Ventricular tachycardia and ventricular aneurysm due to unrecognized sarcoidosis

Cardiac involvement due to sarcoidosis is well recognized. Arrhythmias have been recognized in up to 50% of patients who have cardiac involvement. We report on two patients with no systemic manifestations of sarcoidosis who presented with refractory ventricular tachycardia. Evaluation demonstrated atypical left ventricular "aneurysms" with normal coronary arteries. Surgical pathology demonstrated granulomas consistent with sarcoidosis. Despite extensive surgical resection, they continued to have symptomatic ventricular tachycardia requiring implantation of a defibrillator. Recognition of sarcoidosis as an etiology for ventricular tachycardia and aneurysm is important for possible avoidance of surgery.