title: Isolated primary cardiac sarcoidosis presenting as acute heart failure.
abstract: A 65-year-old man was referred to our hospital due to an acute onset of dyspnea and persistent fever. Echocardiography revealed an ejection fraction (EF) of 25% with diffuse severe left ventricular (LV) dysfunction. 18F-fluorodeoxy glucose-positron emission tomography imaging showed significantly increased uptake by the LV and right ventricular walls, indicating active inflammation. The histologic findings of the endomyocardial biopsy specimens indicated the presence of epithelioid cell granuloma. The final diagnosis was thus cardiac sarcoidosis with acute inflammation. Five-months after the initiation of steroid therapy, echocardiography showed an EF of 50%. This is a rare case in which acute inflammation led to acute heart failure mimicking acute myocarditis.
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Sugizaki
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Junichi
authors.initials: J
authors.lastname: Imanishi
authors.forename: Akihide
authors.initials: A
authors.lastname: Konishi
authors.forename: Tomoya
authors.initials: T
authors.lastname: Yamashita
authors.forename: Toshiro
authors.initials: T
authors.lastname: Shinke
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ishida
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kawai
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000208:Acute Disease; D001707:Biopsy, Needle; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology; D004452:Echocardiography / Q000379:methods; D006333:Heart Failure / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods; D011239:Prednisolone / Q000627:therapeutic use*; D013902:Radiography, Thoracic / Q000379:methods; D018570:Risk Assessment; D012507:Sarcoidosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
chemical_list: D011239:Prednisolone