TY - JOUR
T1 - Successful treatment of cardiac sarcoidosis based on clinical suspicion and advanced cardiac imaging
T2 - A case report
AU - Aguilar-Gallardo, Jose S.
AU - Arreaza, Javier
AU - Omar, Alaa
AU - Lasam, Glenmore
AU - Contreras, Johanna P.
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/8/26
Y1 - 2022/8/26
N2 - Introduction: Confirming the diagnosis of cardiac sarcoidosis (CS) is a challenging task as we often do not count with histopathologic evidence. However, prompt initiation of treatment is sometimes necessary, and advanced cardiac imaging along with key clinical findings can play a crucial role in the diagnostic workup. Patient concerns: A 77-year-old male with a history of heart failure presented with chest pain and shortness of breath. He was found to have an acute drop in left ventricular ejection fraction associated with frequent premature ventricular contractions and nonsustained ventricular tachycardia. Coronary angiogram was negative for acute coronary syndrome. Advanced cardiac imaging with cardiac magnetic resonance raised suspicion of CS, and steroids were started empirically. Endomyocardial biopsy was attempted but was not successful. Diagnosis: The patient's presentation was highly suggestive of cardiac sarcoidosis. Interventions: Corticosteroids, diuresis, guideline-directed medical therapy for heart failure. Outcomes: The patient's symptoms and ventricular arrhythmias improved on steroids. Subsequent FDG-PET revealed increased uptake in a pattern consistent with CS. Conclusion: This clinical scenario highlights the importance of advanced cardiac imaging and clinical findings for the diagnosis of CS and exposes the practical need for a standardized, noninvasive strategy to the diagnosis of CS.
AB - Introduction: Confirming the diagnosis of cardiac sarcoidosis (CS) is a challenging task as we often do not count with histopathologic evidence. However, prompt initiation of treatment is sometimes necessary, and advanced cardiac imaging along with key clinical findings can play a crucial role in the diagnostic workup. Patient concerns: A 77-year-old male with a history of heart failure presented with chest pain and shortness of breath. He was found to have an acute drop in left ventricular ejection fraction associated with frequent premature ventricular contractions and nonsustained ventricular tachycardia. Coronary angiogram was negative for acute coronary syndrome. Advanced cardiac imaging with cardiac magnetic resonance raised suspicion of CS, and steroids were started empirically. Endomyocardial biopsy was attempted but was not successful. Diagnosis: The patient's presentation was highly suggestive of cardiac sarcoidosis. Interventions: Corticosteroids, diuresis, guideline-directed medical therapy for heart failure. Outcomes: The patient's symptoms and ventricular arrhythmias improved on steroids. Subsequent FDG-PET revealed increased uptake in a pattern consistent with CS. Conclusion: This clinical scenario highlights the importance of advanced cardiac imaging and clinical findings for the diagnosis of CS and exposes the practical need for a standardized, noninvasive strategy to the diagnosis of CS.
KW - advance cardiac imaging
KW - cardiac FDG-PET
KW - cardiac magnetic resonance
KW - cardiac sarcoidosis
KW - endomyocardial biopsy
UR - http://www.scopus.com/inward/record.url?scp=85136936354&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000027814
DO - 10.1097/MD.0000000000027814
M3 - Article
C2 - 36042616
AN - SCOPUS:85136936354
VL - 101
SP - E30306
JO - Medicine (United States)
JF - Medicine (United States)
SN - 0025-7974
IS - 34
ER -