Complete diagnostic work-up and prognosis prediction for cardiac sarcoidosis with atrioventricular block: Importance of cardiac magnetic resonance image (MRI) and positron emission tomography (PET)
نویسندگان
چکیده
A 56-year old woman complained of chest discomfort and dyspnea on exertion for one month. She had been diagnosed as mediastinal lymph node sarcoidosis through endobronchial ultrasonography guided transbronchial lymph node aspiration. Electrocardiogram at presentation demonstrated sequential first and second degree 2:1 atrioventricular block. Further imaging study with gadolinium enhanced cardiac magnetic resonance image and 18Ffluoro-2-deoxyglucose positron emission tomography confirmed the diagnosis of sarcoidosis involving heart. Intravenous steroid therapy without pacemaker implantation improved conduction abnormality to normal sinus rhythm. Follow-up 18F-FDG-PET demonstrated full improvement of cardiac and extracardiac lesion with maintenance oral steroid therapy for 5month.
منابع مشابه
Assessment of Cardiac Sarcoidosis with Advanced Imaging Modalities
Sarcoidosis is a chronic systemic disease of unknown etiology that is characterized by the presence of noncaseating epithelioid granulomas, usually in multiple organs. Several studies have shown that sarcoidosis might be the result of an exaggerated granulomatous reaction after exposure to unidentified antigens in genetically susceptible individuals. Cardiac involvement may occur and lead to an...
متن کاملThe prospective study of cardiac MRI in the diagnosis and treatment of cardiac sarcoidosis associated with atrioventricular block
Background Sarcoidosis is systemic granulomatous disease of unknown etiology. Most patients present with pulmonary involvement, but association of cardiac sarcoidosis (CS) is critical factor determining prognosis. Recently, cardiac magnetic resonance imaging (CMR) and 18Ffluoro-2-deoxyglucose positron emission tomography (18F-FDG PET) can detect cardiac lesions in asymptomatic sarcoidosis patie...
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A 54-year-old man with clinically and pathologically diagnosed cutaneous, ocular and pulmonary sarcoidosis was referred to the Cardiology Department for a prolonged PR interval and intermittent advanced atrioventricular block (Picture 1A and B). Echocardiography, gallium-67 scintigraphy and cardiac magnetic resonance imaging revealed no evidence of cardiac sarcoid involvement. F-fluoro-2deoxygl...
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BACKGROUND Sarcoidosis is an inflammatory disorder of immune dysregulation characterized by non-caseating granulomas that can affect any organ. Cardiac sarcoidosis is an under-recognized entity that has a heterogeneous presentation and may occur independently or with any severity of systemic disease. Diagnosing cardiac sarcoidosis remains problematic with endomyocardial biopsies associated with...
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Cardiac sarcoidosis is rare and subclinical involvement is four to five times more common than clinical involvement. Cardiac sarcoidosis is associated with a poor prognosis. ECG abnormalities are the most common presentation. However, as this case illustrates, it can also present as acute decompensated heart failure. Screening with cardiac positron emission tomography (PET) or magnetic resonanc...
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