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Catastrophic Events of Cardiac Sarcoidosis: A Case Report

Maria Riasat1, Arshan Khan2, Moiz Ehtesham3

  • 1Internal Medicine, Icahn School of Medicine Mount Sinai Beth Israel, New York, USA.

Cureus
|June 14, 2022
PubMed

Insights

Cardiac sarcoidosis (CS) can be asymptomatic but lead to sudden death. This case highlights how advanced imaging like FDG-PET can detect myocardial inflammation, guiding treatment and showing recovery in a patient with pulmonary sarcoidosis.

Area of Science:

  • Cardiology
  • Pulmonology
  • Nuclear Medicine

Background:

  • Cardiac sarcoidosis (CS) often presents insidiously, with atrioventricular block or fatal arrhythmias.
  • Endomyocardial biopsy has limited sensitivity for diagnosing CS due to patchy myocardial involvement.

Observation:

  • A female patient presented with syncope and cardiac arrests, initially with unremarkable autoimmune workup.
  • Cardiac MRI showed non-ischemic intramyocardial enhancement, and FDG-PET revealed patchy myocardial uptake.

Findings:

  • Intravenous methylprednisolone treatment led to clinical improvement.
  • Repeat FDG-PET demonstrated resolution of myocardial inflammation.
  • Bronchoscopy with biopsy confirmed pulmonary sarcoidosis with granulomas.

Implications:

  • FDG-PET imaging is valuable for diagnosing cardiac sarcoidosis and monitoring treatment response.
  • Early detection and treatment of CS can prevent life-threatening cardiac events.
  • Integrated diagnostic approaches combining imaging and biopsy are crucial for managing CS.

Keywords:
atrioventricular blockcardiac arrestcardiac sarcoidosisfdg-pet scanpulmonary sarcoid

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