BMJ Case Reports 2011; doi:10.1136/bcr.01.2011.3703
  • Rare disease

Churg–Strauss presenting as acute coronary syndrome: sometimes it’s zebras

  1. Lisa Anderson1
  1. 1Department of Cardiology, Johns Hopkins School of medicine, Baltimore, Maryland, USA
  2. 2St George’s Hospital, Tooting, UK
  3. 3Imperial College London, London, UK
  1. Correspondence to Dr Nicholaos Kakouros, nkakouros{at}


A 53-year-old patient presented to our institution with troponin-positive chest pain and new-onset peripheral oedema. A week prior, while abroad, he had developed visual disturbances and fever in conjunction with an elevated troponin. Coronary angiography had revealed minor coronary artery disease and he was treated for acute coronary syndrome and occult infection. On arrival to our coronary care unit, further review elicited a history of recently diagnosed and worsening severity asthma with nasal polyposis. A mononeuritis and a vasculitic rash were noted and blood screen showed hypereosinophilia and immunoglobulin E (IgE) elevation. A clinical diagnosis of Churg–Strauss syndrome was made and the patient was treated urgently and successfully with immunosuppressants.

The case illustrates a fulminant presentation mode of this rare vasculitis and the importance of seeking a unifying diagnosis in cases presenting with apparently disparate symptoms and findings.


  • Competing interests None.

  • Patient consent Obtained.

No Related Web Pages

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article