What type of different clinical manifestations can cardiac sarcoidosis present?

Rheumatol Int. 2015 Jun;35(6):1103-6. doi: 10.1007/s00296-014-3183-z. Epub 2014 Nov 28.

Abstract

Cardiac sarcoidosis is an infiltrative, granulomatous inflammatory disease of the myocardium. Generally, it can be difficult to diagnose cardiac sarcoidosis clinically because of the non-specific nature of its clinical manifestations. This property can be based on the presence of any clinical evidence of sarcoidosis in the other organs. We present two cases of cardiac sarcoidosis so as to demonstrate its different clinical manifestations. The first patient displayed no cardiac symptoms; the electrocardiogram showed an incidental right bundle branch block. Her cardiac magnetic resonance imaging (CMRI) revealed late-phase opaque material enhancement involving the inferior and inferoseptal segment of the left ventricle. The second patient was severely symptomatic in terms of cardiac involvement, and a transthoracic echocardiogram revealed global hypokinesia and septal brightness; his ejection fraction decreased to 45%. These cases highlighted the challenges encountered in the diagnosis and treatment of cardiac sarcoidosis. CMRI should be considered in all patients who have suspected findings for cardiac involvement.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / drug therapy
  • Arrhythmias, Cardiac / etiology*
  • Arrhythmias, Cardiac / physiopathology
  • Cardiomyopathies / complications*
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / drug therapy
  • Cardiomyopathies / physiopathology
  • Coronary Angiography
  • Disease Progression
  • Drug Substitution
  • Echocardiography
  • Electrocardiography
  • Female
  • Glucocorticoids / therapeutic use
  • Heart Conduction System / physiopathology
  • Humans
  • Hypertrophy, Left Ventricular / diagnosis
  • Hypertrophy, Left Ventricular / drug therapy
  • Hypertrophy, Left Ventricular / etiology*
  • Hypertrophy, Left Ventricular / physiopathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prednisolone / therapeutic use
  • Sarcoidosis / complications*
  • Sarcoidosis / diagnosis
  • Sarcoidosis / drug therapy
  • Sarcoidosis / physiopathology
  • Stroke Volume
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / drug therapy
  • Ventricular Dysfunction, Left / etiology*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Function, Left

Substances

  • Glucocorticoids
  • Prednisolone