Predominant myocardial sarcoidosis

Unexpected autopsy findings of a predominantly myocardial sarcoidosis are reported. For a period of two years prior to death, the 42-year-old man suffered from atypical angina pectoris and ventricular arrythmias with episodic ventricular fibrillation. Echocardiography revealed a non-obstructive hypertrophic cardiomyopathia. He succumbed to sudden cardiac arrest. Sarcoidosis granulomas were widespread in the ventricular and atrial myocardium with intensive involvement of the sinus node, atrioventricular node, and the main bundle of His. According to a review of the previous literature on this subject, an obviously deleterious obstructive granulomatous angiitis of the sinus node's central artery was found for the first time.