Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
+44 1300 500008
ISSN: 2155-9880
+44 1300 500008
Irene Paraskevakis and Vladimir Fridman
Posters: J Clin Exp Cardiolog
Introduction: Sarcoidosis is a life threatening medical condition. It becomes extremely dangerous when it invades the myocardium, as fatal arrhythmias usually develop. When cardiac sarcoid is diagnosed, aggressive anti-arrhythmia treatment needs to be considered to save the lives of affected patients. The purpose of this case report is to show how severely sarcoid can affect the myocardium. Case: A 57 yr old white male with a past medical history of biopsy proven sarcoidosis, not on any medications due to ?insurance issues,? presented to the ER with worsening dyspnea on exertion for 2 months. He also complained of intermittent palpitations, but denied any other associated symptoms. On presentation, his vital signs were within normal limits. His physical exam was remarkable for heart sounds that were irregularly irregular. Labs were unremarkable. The EKG showed atrial fibrillation at 120 bpm with LVH. TEE revealed a left ventricular ejection fraction of 30% and mild left atrial dilation. Cardiac catheterization showed no CAD. Cardiac MRI revealed a nodular focus of delayed enhancement in the lateral inferior wall suggestive of an infiltrating myocarditis such as sarcoidosis. The patient?s heart rate was controlled with medication. He had an ICD placed and was discharged on appropriate medical therapy. Discussion: Sarcoid involvement of the heart can lead to extremely devastating consequences. Whereas ventricular arrhythmias are the most feared, atrial arrhythmias and various stages of conduction disease can arise from direct involvement of the myocardium by sarcoid. Atrial fibrillation and likely resultant cardiomyopathy, as in this case, is rare with cardiac sarcoid. However, it is extremely important for clinicians to suspect cardiac sarcoid when any arrhythmias or cardiac conditions develop in patients with known sarcoidosis. In such cases, cardiac MRI is the gold standard test to diagnose cardiac sarcoid, and if diagnosed, the appropriate specialists should be involved so life saving therapy can be started as quickly as possible. In such cases, cardiac MRI is the gold standard test to diagnose cardiac sarcoid. If cardiac sarcoid is then diagnosed, the appropriate specialists should be involved so life saving therapy can be started as quickly as possible.