Ventricular tachycardia – an atypical initial presentation of sarcoidosis: a case report

Ekka, Meera; Sinha, Sanjeev; Purushothaman, Raghunandan; Naik, Nitish; Narang, Rajiv; Singh, Lavleen

doi:10.1186/1752-1947-7-196

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…In another study, a 41-year-old lady presented with VT and was found to have systemic sarcoidosis with cardiac involvement; she was started on steroids, amiodarone, and metoprolol, and received failed radiofrequency ablation. Unfortunately, the patient passed away due to recurrent VT [ 7 ]. Therefore, maintaining a high index of early suspicion of sarcoidosis in patients presenting with arrhythmias, especially in the absence of CAD, is critical to prevent disease-related mortality.…”

Section: Discussionmentioning

confidence: 99%

A Case of Burnt-Out Cardiac Sarcoidosis Presenting With Sustained Ventricular Tachycardia

Sallam¹,

Shahrori²,

Rana³

et al. 2022

Cureus

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Cardiac sarcoidosis is a challenging clinical entity in terms of diagnosis and management. Cardiac involvement is the most common cause of death in patients with sarcoidosis. Recently, there have been new advancements in the imaging modalities that aid in the diagnosis of this condition, including cardiac MRI and PET scan. These tools can help identify and determine the extent of the progression of sarcoidosis, which can have diagnostic and therapeutic implications. In this report, we present the case of a 74-year-old man with no history of sarcoidosis who presented with sustained ventricular tachycardia (VT) and was subsequently found to have findings consistent with burnt-out sarcoidosis on imaging. This case highlights the differences in the management of various stages of cardiac sarcoid involvement to reduce adverse outcomes.

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Section: Discussionmentioning

confidence: 99%

A Case of Burnt-Out Cardiac Sarcoidosis Presenting With Sustained Ventricular Tachycardia

Sallam¹,

Shahrori²,

Rana³

et al. 2022

Cureus

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“…The course of sarcoidosis can be silent, but serious complications in cardiac sarcoidosis can lead to sudden cardiac death. Cardiac involvement is an independent cursor of mortality and associated with poor survival [2].…”

Section: Discussionmentioning

confidence: 99%

What type of different clinical manifestations can cardiac sarcoidosis present?

Şentürk¹,

Maraş²,

Argüder³

et al. 2014

Rheumatol Int

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Cardiac sarcoidosis is an infiltrative, granulomatous inflammatory disease of the myocardium. Generally, it can be difficult to diagnose cardiac sarcoidosis clinically because of the non-specific nature of its clinical manifestations. This property can be based on the presence of any clinical evidence of sarcoidosis in the other organs. We present two cases of cardiac sarcoidosis so as to demonstrate its different clinical manifestations. The first patient displayed no cardiac symptoms; the electrocardiogram showed an incidental right bundle branch block. Her cardiac magnetic resonance imaging (CMRI) revealed late-phase opaque material enhancement involving the inferior and inferoseptal segment of the left ventricle. The second patient was severely symptomatic in terms of cardiac involvement, and a transthoracic echocardiogram revealed global hypokinesia and septal brightness; his ejection fraction decreased to 45%. These cases highlighted the challenges encountered in the diagnosis and treatment of cardiac sarcoidosis. CMRI should be considered in all patients who have suspected findings for cardiac involvement.

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“…Corticosteroids should be administered in doses of 1mg/kg/day, and then tapered after 2-3months, to 10-20mg every other day. [20][21][22][23][24][25][26][27][28] ICD placement should be strongly considered in this population, especially in patients with evidence of extensive myocardial damage and fibrosis or in the presence of arrhythmias, as studies have shown an increased rate of adverse events and sudden cardiac death. As such, placement of an ICD for primary prevention is a Class IIa recommendation.…”

Section: Treatmentmentioning

confidence: 99%

Untitled

2019

HTIJ

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Introduction: Sarcoidosis can be a benign, incidentally discovered condition or a lifethreatening disorder causing sudden death. The frequency of myocardial involvement is unclear; small registries suggest 5 percent of patients with systemic sarcoidosis, while autopsy studies suggest subclinical cardiac involvement in up to 70 percent. The range of sarcoid involvement of the heart includes heart block and arrhythmias, heart failure, valvular dysfunction, simulated infarction, and pericardial disease. Case Description: 37 year-old African American female with past medical history of presumed asthma presented to the emergency room complaining of progressively worsening dyspnea, chest pain and lightheadedness. Physical examination showed tachycardia with displaced point of maximal impulse (PMI) and minimal rhonchi on right lung base. Laboratory workup did not show any significant results on presentation. Chest X-ray showed bilateral interstitial infiltrates and the chest Computed Tomography (CT) Angiogram showed bilateral scattered pulmonary nodules, right-sided pleural effusion with thickening. Lung biopsy showed non-caseating granulomas typical of sarcoidosis. Further workup revealed Ejection Fraction (EF) of 25% on Transthoracic Echocardiogram (TTE), cardiac catheterization showed normal coronaries and electrophysiological study for inducible arrhythmias was negative. Conclusion: Cardiac sarcoidosis may be suddenly fatal. Therefore, clinicians must maintain a high degree of suspicion for cardiac involvement and screen all patients with extra cardiac sarcoidosis. Despite significant advances in immunosuppressant pharmacotherapy, the backbone of therapy for cardiac sarcoidosis remains systemic corticosteroids.

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Ventricular tachycardia – an atypical initial presentation of sarcoidosis: a case report

Cited by 4 publications

References 19 publications

A Case of Burnt-Out Cardiac Sarcoidosis Presenting With Sustained Ventricular Tachycardia

A Case of Burnt-Out Cardiac Sarcoidosis Presenting With Sustained Ventricular Tachycardia

What type of different clinical manifestations can cardiac sarcoidosis present?

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