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Quarrying is the process of extracting stone from a quarry, where specialized techniques are employed to remove large blocks of stone safely and efficiently. This process can involve controlled explosions or more precision-oriented methods such as cutting and drilling.
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Imaging Cleared Embryonic and Postnatal Hearts at Single-cell Resolution
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The Cobblestone Heart.

W J Tan1, C S Suz2, O Azza2

  • 1Hospital Raja Perempuan Zainab II, Department of Medicine, Kota Bharu, Malaysia. tanwangjie@gmail.com.

The Medical Journal of Malaysia
|March 20, 2021
PubMed
Summary
This summary is machine-generated.

A woman with worsening respiratory symptoms was initially misdiagnosed with tuberculosis. Advanced imaging and biopsy confirmed pulmonary sarcoidosis with cardiac involvement, leading to improved health with immunosuppressants.

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Area of Science:

  • Pulmonology
  • Cardiology
  • Immunology

Background:

  • Sarcoidosis is a complex multisystem inflammatory disease.
  • Early diagnosis can be challenging, often mimicking other conditions like tuberculosis.
  • Cardiac involvement significantly impacts prognosis and management.

Purpose of the Study:

  • To report a case of pulmonary sarcoidosis with cardiac involvement.
  • To highlight diagnostic challenges and the importance of advanced imaging.
  • To illustrate the effectiveness of immunosuppressive therapy.

Main Methods:

  • Case presentation of a 38-year-old female with persistent cough and dyspnea.
  • Diagnostic workup included CT thorax, pleural biopsy, and cardiac MRI.
  • Treatment involved immunosuppressive therapy with a tapering dosage regimen.

Main Results:

  • Initial misdiagnosis as smear-negative pulmonary tuberculosis.
  • Deterioration of New York Heart Association (NYHA) functional class from 1 to 3.
  • Confirmation of pulmonary sarcoidosis with cardiac involvement via CT, biopsy (non-caseating granuloma), and cardiac MRI (late gadolinium enhancement).
  • Significant improvement in functional status and cough after immunosuppressant treatment.

Conclusions:

  • Sarcoidosis can present insidiously and be misdiagnosed.
  • Multimodality imaging and tissue biopsy are crucial for accurate diagnosis.
  • Early recognition and appropriate immunosuppressive treatment can improve outcomes in cardiac sarcoidosis.