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Rapidly progressive atrioventricular block in a patient with sarcoidosis

Nagham Saeed Jafar1, Warkaa Al Shamkhani1, Sunil Roy Thottuvelil Narayanan1

  • 1Department of Cardiology, Belhoul Speciality Hospital, P.O. Box 5527, Dubai, UAE.

Case Reports in Cardiology
|September 13, 2014
PubMed

Insights

Cardiac sarcoidosis can cause severe heart block, even in young patients. Early suspicion is key, as atrioventricular (AV) block may be the sole indicator of this serious condition.

Area of Science:

  • Cardiology
  • Immunology
  • Internal Medicine

Background:

  • Cardiac sarcoidosis is a significant cause of mortality in systemic sarcoidosis patients.
  • Cardiac involvement occurs in 2.3% of patients, with atrioventricular (AV) block being a common manifestation.
  • AV block can be the primary or only sign of sarcoidosis, even without pulmonary symptoms.

Purpose of the Study:

  • To highlight the importance of considering sarcoidosis in young patients presenting with atrioventricular (AV) block.
  • To describe a case of rapidly progressing AV block due to cardiac sarcoidosis in a young male.

Main Methods:

  • Case report of a young male with exercise-induced AV block.
  • ECG analysis revealing rapidly progressive conduction abnormalities.
  • Evaluation for underlying causes, including sarcoidosis, in the absence of coronary artery disease.

Main Results:

  • The patient presented with exercise-induced atrioventricular (AV) block, rapidly progressing to complete heart block.
  • Recurrent syncope necessitated urgent pacemaker implantation.
  • A history of cutaneous sarcoidosis and the patient's young age supported an infiltrative process diagnosis.

Conclusions:

  • Young patients with AV block should be evaluated for sarcoidosis.
  • Cardiac sarcoidosis can present solely with conduction abnormalities, emphasizing the need for high clinical suspicion.
  • Prompt diagnosis and management are crucial for preventing adverse outcomes in cardiac sarcoidosis.

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