Sarcoidosis: a pattern of clinical and morphological presentation

Area of Science:

• Cardiology
• Immunology
• Medical Imaging

Background:

• Cardiac sarcoidosis diagnosis is often delayed due to nonspecific symptoms.
• Overt systemic involvement is not always present, complicating early detection.
• Left ventricular wall motion abnormalities are key echocardiographic findings.

Purpose of the Study:

• To evaluate the utility of echocardiography and angiography in diagnosing cardiac sarcoidosis.
• To identify specific patterns of left ventricular wall motion abnormalities indicative of myocardial sarcoidosis.
• To highlight the importance of recognizing these patterns even in the absence of systemic sarcoidosis.

Main Methods:

• Retrospective analysis of five patients diagnosed with sarcoidosis.
• Echocardiography to assess left ventricular wall motion.
• Angiography to corroborate echocardiographic findings.

Main Results:

• Three patients exhibited basal septal and free wall motion abnormalities with apical sparing.
• Two patients showed diffuse hypokinesia with anteroapical focal abnormalities.
• Angiographic findings were atypical for ischemic heart disease, supporting echocardiographic observations.

Conclusions:

• Focal wall motion abnormalities in the basal ventricular septum suggest myocardial sarcoidosis.
• Echocardiography and angiography are crucial for diagnosing cardiac sarcoidosis.
• Early recognition of these imaging patterns aids timely diagnosis and management.