Sarcoidosis mimicking ischaemic ventricular arrhythmia and pulmonary embolism.
Sarcoidosis is a multisystem granulomatous disorder characterised pathologically by the presence of noncaseating granulomas in the organs involved. Cardiac involvement, although well known, is rare. We describe a 72-year-old patient who was admitted to the intensive care unit after coronary artery bypass grafting. She developed refractory right and left ventricular failure complicated by multiple organ failure and died three days later. Postmortem examination revealed extensive sarcoidosis. On hindsight, preoperative ventricular tachycardia and an abnormal perfusion-ventilation scintigraphy of the lungs were manifestations of an underlying sarcoidosis.
de Jager
C P C
CP
Department of Intensive Care, VU University Medical Centre, Amsterdam, The Netherlands. P.de.jager@jbz.nl
Jessurun
E R
ER
Jansen
E K
EK
Verheij
J
J
Girbes
A R J
AR
Strack van Schijndel
R J M
RJ
D000368:Aged; D001707:Biopsy, Needle; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods; D003937:Diagnosis, Differential; D018450:Disease Progression; D004636:Emergency Service, Hospital; D017809:Fatal Outcome; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000473:pathology; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000628:therapy; D012507:Sarcoidosis / Q000175:diagnosis / Q000473:pathology*; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000188:drug therapy