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Isolated cardiac sarcoidosis associated with coronary vasomotion abnormalities: a case report

Shigeo Godo1, Yuhi Hasebe1, Jun Takahashi1

  • 1Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.

European Heart Journal. Case Reports
|June 7, 2022
PubMed

Insights

Cardiac sarcoidosis can cause coronary artery spasm, affecting heart function. Treatment with corticosteroids and calcium-channel blockers may reduce spasm and inflammation.

Area of Science:

  • Cardiology
  • Inflammatory Diseases
  • Medical Imaging

Background:

  • Cardiac sarcoidosis is a serious inflammatory heart condition leading to heart failure and arrhythmias.
  • Diagnosis of isolated cardiac sarcoidosis can be achieved using imaging techniques, avoiding invasive biopsy.
  • Coronary vasomotion abnormalities are common in cardiovascular and inflammatory conditions, but their link to cardiac sarcoidosis was unclear.

Observation:

  • A patient with cardiac sarcoidosis experienced cardiac arrest due to ventricular fibrillation.
  • Coronary angiography revealed normal arteries, but acetylcholine testing showed epicardial and microvascular spasm.
  • Diagnosis of isolated cardiac sarcoidosis was confirmed through established criteria, including imaging findings.

Findings:

  • Active myocardial inflammation in cardiac sarcoidosis is associated with both epicardial and coronary microvascular spasm.
  • Treatment combining corticosteroids for sarcoidosis and calcium-channel blockers for spasm led to reduced coronary artery spasm.
  • Therapy resulted in regression of myocardial inflammation alongside improved coronary vasomotion.

Implications:

  • Coronary vasomotion abnormalities should be considered in patients with cardiac sarcoidosis.
  • Combined treatment strategies can effectively manage coronary spasm and inflammation in cardiac sarcoidosis.
  • This highlights a potential therapeutic target for improving outcomes in cardiac sarcoidosis patients.
Abstract

Keywords:
Case reportCoronary artery spasmCoronary microvascular spasmIsolated cardiac sarcoidosis

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