title: Postpartum complete atrioventricular block due to cardiac sarcoidosis: steroid therapy without permanent pacemaker.
abstract: A 32 year-old woman with bilateral hilar lymphadenopathy suffered from syncopal attacks after her first delivery. Electrocardiograms showed complete atrioventricular block (AVB) and myocardial scintigrams demonstrated a decreased uptake in the anteroseptal area. She was diagnosed as having postpartal cardiac acceleration of sarcoidosis. Because she rejected permanent pacemaker implantation, we started steroid therapy under temporary pacing. Fortunately, the treatment was very effective. Even after tapering-off of the steroid, the AVB has never reappeared. Permanent pacemaker implantation with subsequent steroid therapy is generally recommended for complete AVB due to cardiac sarcoidosis. However, steroid therapy alone can be considered for some selected cases.
authors.affiliation: Department of Cardiology, JR Tokyo General Hospital, Shibuya-ku, Tokyo, Japan.
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugishita
authors.forename: Yuki
authors.initials: Y
authors.lastname: Togashi
authors.forename: Akira
authors.initials: A
authors.lastname: Aizawa
authors.forename: Masako
authors.initials: M
authors.lastname: Asakawa
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Usui
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Ito
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Hada
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D054537:Atrioventricular Block / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D009202:Cardiomyopathies / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D010138:Pacemaker, Artificial; D049590:Postpartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011859:Radiography; D011877:Radionuclide Imaging; D012507:Sarcoidosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy
chemical_list: D005938:Glucocorticoids