# Idiopathic hypereosinophilic syndrome associated with multivessel coronary artery ectasia: a case report

## TL;DR

A rare case of a blood condition called idiopathic hypereosinophilic syndrome is linked to unusual heart artery issues, highlighting the need for thorough heart checks in such patients.

## Contribution

Reports a rare association between idiopathic hypereosinophilic syndrome and multivessel coronary artery ectasia.

## Key findings

- A patient with idiopathic hypereosinophilic syndrome had extensive coronary artery ectasia and a critical stenosis.
- Treatment with corticosteroids, immunosuppressants, and antiplatelet therapy led to a favorable outcome.
- The case suggests eosinophil-mediated vascular injury in the syndrome.

## Abstract

We report a rare case of idiopathic hypereosinophilic syndrome (iHES) associated with extensive multivessel coronary artery ectasia (CAE), a vascular complication seldom described in this condition. A 56-year-old man with known iHES presented with progressive exertional chest pain. Coronary angiography revealed diffuse ectasia of all major epicardial coronary arteries, with a critical stenosis in the mid-right coronary artery. Secondary causes of eosinophilia were excluded, and no clinical or serological evidence of vasculitis or connective tissue disease was found. The patient was treated with corticosteroids, immunosuppressants, and dual antiplatelet therapy, with a favorable outcome. This case illustrates the potential for eosinophil-mediated vascular injury in iHES and emphasizes the need for comprehensive cardiovascular assessment in patients with persistent hypereosinophilia, even in the absence of systemic symptoms. Increased awareness of this underrecognized manifestation may help guide timely diagnosis and management.