Churg-Strauss Syndrome (CSS) complicated with
cardiogenic shock is rare. Few case reports have described successful treatment of this
rare disease. However, no one has reported on the application of mechanical life support with
extracorporeal membrane oxygenation (ECMO) to treat this life-threatening disease.A 36-year-old female with limb
numbness for >10 days, chest tightness for 2 days, and worsening
dyspnea for 5 h presented in the emergency room. Vital signs showed a
low blood pressure (104/60 mm Hg), increased heart rate (158 bpm), and respiration rate (28 bpm). Laboratory tests revealed that eosinophil was significantly increased (WBC: 34.46 × 10/L, neutrophil: 7.56 × 10/L[21.9%], eosinophil: 23.84 × 10/L[69.2%]), and serum myocardial
enzymes was abnormal (CK 1049U/L, CKMB-mass 145.1 μg/L, cTnI 16.24 μg/L). Myocardial injury (
tachycardia with ST elevation) and poor heart function (LVEF 31%) were found by electrocardiogram and transthoracic echocardiography. On the next day,
cardiogenic shock had been developed as demonstrated by deteriorating the perfusion index.Churg-Strauss Syndrome with
cardiogenic shock.A series of
conservative therapy with drugs such as
corticosteroids,
anticoagulant, antiplatelet,
nitrates,
calcium antagonists, inotrope, and vasopressors were initiated on the day of admission. The treatment was ineffective and a
cardiogenic shock developed on the next day. Thus, ECMO was initiated immediately to stabilize circulation and perfusion. At the same time, high-dose
corticosteroids combined with immunosuppressive therapy were continuously used.Symptoms of
cardiogenic shock were gradually improved after
ECMO treatment. Elevated values of cardiac
enzymes were decreased and the dose of vasoactive drugs was reduced.
Extracorporeal membrane oxygenation was discontinued after 8 days, and the patient was eventually weaned off the
ventilator. The patient was discharged after 40 days treatment.Once a CSS develops into a
cardiogenic shock, the ECMO should be considered as an alternative
therapeutics in that it stabilizes hemodynamic status, maintains effective tissue perfusion, and provides an opportunity for the recovery of cardiac function.