The intricacies of cardiac sarcoidosis: a case report involving the coronary arteries and a review of the literature.
BACKGROUND
Primary cardiac sarcoidosis (CS) is rare, and concomitant involvement of the coronary arteries is rarer still. Successful diagnosis of this disease is difficult due to its nonspecific symptoms which mimic those of idiopathic dilated cardiomyopathy (IDCM).


RESULTS
We describe a 47-year-old Caucasian male who underwent orthotopic heart transplant for presumed IDCM. Examination of the explanted heart revealed numerous nonnecrotizing granulomata throughout, similar granulomata in the walls of the large coronary arteries, and large areas of fibrosis.


CONCLUSIONS
In cases of IDCM with symptoms of angina or acute coronary syndrome, the possibility of CS should be considered. Herein, we present this case and a review of the relevant literature.
Butany
Jagdish
J
Department of Pathology, Toronto General Hospital/University Health Network, Toronto, Canada. jagdish.butany@uhn.on.ca
Bahl
Nina E
NE
Morales
Kathy
K
Thangaroopan
Molly
M
Ross
Heather
H
Rao
Vivek
V
Leong
Shaun W
SW
D000787:Angina Pectoris / Q000209:etiology; D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000473:pathology*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005355:Fibrosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D012507:Sarcoidosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography