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Nam Tran, Chun Shing Kwok, Thanh Phan and Sadie Bennett

A 62-year old female was admitted with severe left sided chest pain, nausea and pre-syncope. She had widespread T wave inversion on electrocardiogram and elevated troponins and was suspected to have an acute coronary syndrome event. Invasive coronary angiogram revealed normal coronary anatomy with no flow limiting lesions. Echocardiography and cardiac magnetic resonance imaging revealed impaired left ventricular (LV) systolic impairment, a mobile LV apical thrombus and a moderate global pericardial effusion with no significant compromise. Full blood count analysis indicated the patient to have significant eosinophilia and the patient was diagnosed with idiopathic eosinophilic myocarditis. She was commenced on Prednisolone and Apixaban and eosinophil levels returned to normal after 10 days of steroids. Over the course of three months, the patient had a complete recovery of her LV function and resolution of the LV thrombus. This case highlights a rare, reversible case of idiopathic eosinophilic myocarditis which may present similar to acute coronary syndrome.