Resuscitated Cardiac Arrest From Cardiac Sarcoidosis in a Professional Basketball Player: A Slam Dunk Diagnosis?

Cardiac sarcoidosis is associated with malignant arrhythmias, and athletes with implantable cardioverter-defibrillators (ICDs) have historically been restricted from competition.

A 34-year old professional basketball player experienced cardiac arrest due to monomorphic ventricular tachycardia during competition, however cardiopulmonary resuscitation with automated external defibrillator use led to immediate cardioversion. Work-up revealed findings of probable cardiac sarcoidosis according to current criteria. He was treated with steroids, and an ICD was placed with no further arrhythmia. With shared decision-making, he returned to competition.

The evaluation of cardiac arrest requires coronary, genetic, and myocardial interrogation, with myocardial processes best evaluated using advanced imaging and, selectively, endomyocardial biopsy. Recent data suggest the safety of ICD use in athletes.

The diagnosis of cardiac sarcoidosis relies largely on clinical findings and noninvasive imaging and exists on a spectrum of definite, probable, possible, or unlikely. Return to play after ICD implantation is an important consideration in competitive athletes with sudden cardiac arrest and requires shared decision-making.