Undiagnosed cardiac sarcoidosis presenting as complete heart block and ventricular arrhythmia.
Cardiac involvement in sarcoidosis has been reported to be as high as 50% of cases and it is well documented that it is associated with a poorer prognosis. Early recognition and treatment is key to reducing the risk of fatal arrhythmias and heart failure. We report a case of undiagnosed systemic sarcoidosis in a young man who initially presented to the emergency department with complete heart block in the context of preserved biventricular systolic function, and then again with ventricular tachycardia and moderately impaired left ventricular systolic function. We discuss how 18F-fluorodeoxyglucose positron emission tomography with CT was used for accurate diagnosis and how its role in the management of sarcoidosis has expanded with recent evidence suggesting it to be a mainstay of management and disease monitoring in cardiac sarcoidosis.
Department of Cardiology, King George Hospital and Barking, Havering, Redbridge NHS Trust, London, UK.
Kyle
K
Mcbeath
Department of Cardiology, King George Hospital and Barking, Havering, Redbridge NHS Trust, London, UK.
Shohreh
S
Honarbakhsh
Department of Cardiology, King George Hospital and Barking, Havering, Redbridge NHS Trust, London, UK.
Mohammad
M
Chowdhury
Department of Cardiology, King George Hospital and Barking, Havering, Redbridge NHS Trust, London, UK.
Fahad
F
Farooqi
D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000628:therapy; D017147:Defibrillators, Implantable; D019788:Fluorodeoxyglucose F18; D006327:Heart Block / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000628:therapy; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000628:therapy
D019788:Fluorodeoxyglucose F18