Isolated Cardiac Sarcoidosis Presenting as High-Degree Atrioventricular Block

Area of Science:

• Cardiology
• Immunology
• Pathology

Background:

• Isolated cardiac sarcoidosis is a rare manifestation of systemic sarcoidosis.
• Diagnostic and therapeutic strategies remain challenging for clinicians.
• It can present with varied symptoms, from asymptomatic cases to sudden cardiac death.

Observation:

• A 79-year-old male presented with sinus bradycardia and high-degree atrioventricular block post-ureteral stent replacement.
• Common causes of atrioventricular block were excluded through comprehensive evaluation.
• Advanced cardiac imaging was crucial in identifying cardiac sarcoidosis.

Findings:

• Computed tomography of the chest showed no signs of pulmonary involvement or lymphadenopathy.
• The absence of extracardiac disease supported a diagnosis of isolated cardiac sarcoidosis.
• The patient's condition was attributed to cardiac sarcoidosis.

Implications:

• This case highlights the importance of considering rare etiologies like isolated cardiac sarcoidosis in elderly patients with heart block.
• Advanced imaging modalities are vital for accurate diagnosis when typical causes are ruled out.
• Management involved biventricular implantable cardioverter defibrillator placement and corticosteroid therapy.