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Cardiac sarcoidosis completely mimicking biventricular arrhythmogenic cardiomyopathy

András Vereckei1, Gábor Katona1, Katalin Révész1

  • 1Department of Medicine and Hematology, Semmelweis University, Budapest, Hungary.

ESC Heart Failure
|August 31, 2022
PubMed

Insights

Cardiac sarcoidosis (CS) mimics other heart conditions like arrhythmogenic cardiomyopathy (ACM). Autopsy confirmed CS in a patient initially diagnosed with ACM, highlighting diagnostic challenges.

Area of Science:

  • Cardiology
  • Pathology
  • Medical Diagnostics

Background:

  • Cardiac sarcoidosis (CS) presents diverse symptoms, often mimicking other cardiac diseases such as arrhythmogenic cardiomyopathy (ACM).
  • Accurate differentiation between CS and ACM is clinically significant for appropriate patient management and prognosis.

Observation:

  • A 70-year-old female initially diagnosed with biventricular ACM showed symptoms of heart failure.
  • Extracardiac sarcoidosis signs appeared later, but initial diagnostic tests for CS were inconclusive.
  • The patient unfortunately passed away from sepsis with multiorgan failure, with autopsy confirming CS.

Findings:

  • A recently developed ECG algorithm, applied retrospectively, suggested CS in 2015, challenging the initial ACM diagnosis.
  • Autopsy confirmed cardiac sarcoidosis, validating the retrospective ECG algorithm's diagnostic capability.

Implications:

  • This case emphasizes the diagnostic challenge of CS and its potential to mimic ACM.
  • The new ECG algorithm shows promise for improving the early and accurate differential diagnosis of CS versus ACM.
  • Highlighting the need for continuous evaluation of diagnostic tools in complex cardiac cases.

Keywords:
arrhythmogenic cardiomyopathyelectrocardiographyheart failuresarcoidosis

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