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Isolated Cardiac Sarcoidosis Masquerading as Peripheral Vertigo: A Case Report.

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Diagnosing cardiac sarcoidosis, a rare heart condition, is challenging without lung issues. Advanced imaging and repeated cardiac evaluations are crucial for timely diagnosis and improved patient outcomes.

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Area of Science:

  • Cardiology
  • Oncology
  • Immunology

Background:

  • Cardiac sarcoidosis is a rare cause of cardiomyopathy, often presenting insidiously.
  • Diagnosis is particularly challenging in the absence of pulmonary involvement.

Observation:

  • A 70-year-old male initially presented with giddiness and fatigue, misdiagnosed as peripheral vertigo.
  • Initial cardiac evaluations, including physical exam and echocardiography, were normal, ruling out cardiac causes.
  • Development of chest pain and fatigue prompted further investigation.

Findings:

  • Cardiac echocardiography revealed a possible scar.
  • Cardiac MRI demonstrated epicardial late gadolinium enhancement in the left ventricle.
  • FDG PET-CT scan showed diffuse left ventricular hypermetabolism, confirming cardiac sarcoidosis.

Implications:

  • This case underscores the necessity of serial cardiac assessments in patients with unexplained symptoms.
  • Advanced imaging modalities like cardiac MRI and FDG PET-CT are vital for diagnosing cardiac sarcoidosis.
  • Prompt diagnosis and treatment, including ICD insertion and medical therapy, led to significant symptom improvement.