title: Ventricular tachycardia as the first manifestation of cardiac sarcoidosis.
abstract: The case of a 32-year-old man with sustained ventricular tachycardia and hypotension is described. Following pharmacological treatment the patient switched to a sinus rhythm and was transferred to a university hospital for further diagnostic procedures and treatment. Cardiac catherisation ruled out underlying coronary artery disease, and cardiac MRI as well as echocardiography demonstrated a moderately reduced left ventricular ejection fraction, marked thickening of the interventricular septum and extensive intramural and epicardial infiltration of both ventricles. Endomyocardial biopsies were inconclusive; an implantable cardioverter defibrillator (ICD) was implanted in order to prevent a fatal arrhythmic event. Only repeated lymph node biopsies revealed typical findings of granulomatous disease, which together with the clinical course and the cardiac MRI findings strongly supported cardiac sarcoidosis. A few days after initiation of therapy with corticosteroids, the patient experienced the first of a number of ICD discharges, demanding aggressive anti-arrhythmic treatment regimen for the future.
authors.affiliation: Charité University Medicine Berlin, Cardiology, Augustenburger Platz 1, Berlin, 13353, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Mehrhof
authors.forename: Martin
authors.initials: M
authors.lastname: Stockburger
authors.forename: Hartwig
authors.initials: H
authors.lastname: Schuette
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Haverkamp
authors.forename: Rainer
authors.initials: R
authors.lastname: Dietz