title: Cardiac sarcoidosis mimicking right ventricular dysplasia.
abstract: A 59-year-old woman with skin sarcoidosis was admitted to hospital for assessment of complete atrioventricular block. Cross-sectional echocardiography showed that the apical free wall of the right ventricle was thin and dyskinetic with dilation of the right ventricle. Thallium-201 myocardial imaging revealed a normal distribution. Both gallium-67 and technetium-99m pyrophosphate scintigraphy revealed no abnormal uptake in the myocardium. Right ventriculography showed chamber dilation and dyskinesis of the apical free wall, whereas left ventriculography showed normokinesis, mimicking right ventricular dysplasia. Cardiac sarcoidosis was diagnosed on examination of an endomyocardial biopsy specimen from the right ventricle. A permanent pacemaker was implanted to manage the complete atrioventricular block. After steroid treatment, electrocardiography showed first-degree atrioventricular block and echocardiography revealed an improvement in the right ventricular chamber dilation. Reports of cardiac sarcoidosis mimicking right ventricular dysplasia are extremely rare and as this case shows, right ventricular involvement may be one of its manifestations.
authors.affiliation: Second Department of Medicine, Kyoto Prefectural University of Medicine, Japan. jun@gemini.kpu-m.ac.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tatsumi
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Shimoo
authors.forename: Asako
authors.initials: A
authors.lastname: Katsume
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mani
authors.forename: Miyuki
authors.initials: M
authors.lastname: Kobara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shirayama
authors.forename: Akihiro
authors.initials: A
authors.lastname: Azuma
authors.forename: Masao
authors.initials: M
authors.lastname: Nakagawa
mesh_terms: D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000175:diagnosis*; D009202:Cardiomyopathies / Q000175:diagnosis*; D003937:Diagnosis, Differential; D020820:Dyskinesias; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D010490:Pericardial Effusion; D015635:Radionuclide Ventriculography; D012507:Sarcoidosis / Q000175:diagnosis*; D018497:Ventricular Dysfunction, Right