Stages of cardiac pathology in HES
| Stages of cardiac involvement in HES | Characterisation of stage |
|---|---|
| Acute necrosis | Eosinophilic myocarditis with eosinophilic and lymphocytic infiltration. Myocardiac necrosis and apoptosis with rare microembolic phenomena. Typically no other cardiac symptoms. Rarely can exhibit a fulminant course. |
| Thrombotic stage | Thrombus along damaged endocardium. Thrombi within apices of one of both ventricles, and can encroach on base of the heart into the subvalvular regions. Embolic phenomena can occur. |
| Fibrotic stage | Thrombi are replaced by fibrosis. Scarring occurs. Restrictive cardiomyopathy with signs and symptoms of left or right sided heart failure. Fibrosis that occurs at the base of the heart can lead to valvular regurgitation. |
HES, hypereosinophilic syndrome.