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Ischemic Heart Disease: Overview01:17

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
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Isolated cardiac sarcoidosis presenting as transient ischemic attack.

Moises A Vasquez1, Sharon Andrade-Bucknor2

  • 1Department of Internal Medicine University of Miami Miller School of Medicine/Jackson Memorial Hospital Miami Florida USA.

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Cardiac sarcoidosis can rarely cause transient ischemic attacks (TIAs) or stroke. Early diagnosis and treatment are crucial for patients with cardiac disease and new neurological symptoms.

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Area of Science:

  • Cardiology
  • Neurology
  • Immunology

Background:

  • Cardiac sarcoidosis is a rare granulomatous disease affecting the heart.
  • It can manifest with various cardiac issues, including heart failure and arrhythmias.
  • Cerebrovascular events like stroke are uncommon initial presentations.

Observation:

  • A 54-year-old female presented with recurrent TIAs.
  • Initial cardiac evaluation showed no left ventricular dysfunction, but cardiomyopathy was later diagnosed.
  • Cardiac MRI revealed ventricular abnormalities and diffuse myocardial enhancement; PET/CT showed increased FDG uptake.

Findings:

  • A left ventricular apical thrombus was identified, indicating a cardioembolic source for TIAs.
  • The patient was treated with anticoagulation, prednisone, methotrexate, and adalimumab.
  • Treatment led to thrombus resolution and improved cardiac function.

Implications:

  • This case underscores the importance of considering cardiac sarcoidosis in patients with unexplained TIAs/stroke and cardiac findings.
  • Further research is needed to understand the mechanisms of cardioembolism in cardiac sarcoidosis.
  • Targeted therapies may improve outcomes for patients with cardiac sarcoidosis-related cerebrovascular events.