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

Ekka M, Sinha S, Purushothaman R, Naik N, Narang R, Singh L - J Med Case Rep (2013)

Bottom Line: Although clinically apparent cardiac sarcoidosis is an uncommon entity, ventricular tachyarrhythmias as the first presenting symptom are very rare.We discuss the case of a 41-year-old Asian woman who presented to our hospital with intermittent palpitation and on evaluation was diagnosed to have systemic sarcoidosis with cardiac involvement.She was started on multiple antiarrhythmic drugs and corticosteroids without any satisfactory response.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, All India Institute of Medical Sciences, New Delhi, India. drsanjeevsinha2002@yahoo.com.

ABSTRACT

Introduction: Symptomatic cardiac involvement is seen in less than 5% of all cases of sarcoidosis. Although clinically apparent cardiac sarcoidosis is an uncommon entity, ventricular tachyarrhythmias as the first presenting symptom are very rare.

Case presentation: We discuss the case of a 41-year-old Asian woman who presented to our hospital with intermittent palpitation and on evaluation was diagnosed to have systemic sarcoidosis with cardiac involvement. She was started on multiple antiarrhythmic drugs and corticosteroids without any satisfactory response.

Conclusions: Our case report indicates that sarcoidosis can manifest as ventricular tachycardia without any detectable systemic findings. This makes sarcoidosis an important diagnostic consideration in patients with ventricular tachycardia of unknown origin given the high mortality associated with ventricular tachyarrhythmias.

No MeSH data available.


Related in: MedlinePlus

Cardiac magnetic resonance imaging (contrast enhanced) showing enhancement of anteroseptal left ventricular region (long arrow).
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Figure 5: Cardiac magnetic resonance imaging (contrast enhanced) showing enhancement of anteroseptal left ventricular region (long arrow).

Mentions: Holter monitoring showed recurrent episodes of sustained monomorphic VT. Her coronary angiogram was normal. Her echocardiography revealed a left ventricular ejection fraction (EF) of 48% with hypokinesia of the mid-basal interventricular septum (IVS). Cardiac magnetic resonance imaging (MRI) with gadolinium contrast showed evidence of late enhancement in both the apical and anteroseptal left ventricular regions suspicious for fibrosis (Figure 5). To further confirm the diagnosis of cardiac involvement, endomyocardial biopsies were performed. However, her endomyocardial biopsies did not reveal granulomas, but showed focal interstitial fibrosis (Figure 6a, 6b).


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

Ekka M, Sinha S, Purushothaman R, Naik N, Narang R, Singh L - J Med Case Rep (2013)

Cardiac magnetic resonance imaging (contrast enhanced) showing enhancement of anteroseptal left ventricular region (long arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750302&req=5

Figure 5: Cardiac magnetic resonance imaging (contrast enhanced) showing enhancement of anteroseptal left ventricular region (long arrow).
Mentions: Holter monitoring showed recurrent episodes of sustained monomorphic VT. Her coronary angiogram was normal. Her echocardiography revealed a left ventricular ejection fraction (EF) of 48% with hypokinesia of the mid-basal interventricular septum (IVS). Cardiac magnetic resonance imaging (MRI) with gadolinium contrast showed evidence of late enhancement in both the apical and anteroseptal left ventricular regions suspicious for fibrosis (Figure 5). To further confirm the diagnosis of cardiac involvement, endomyocardial biopsies were performed. However, her endomyocardial biopsies did not reveal granulomas, but showed focal interstitial fibrosis (Figure 6a, 6b).

Bottom Line: Although clinically apparent cardiac sarcoidosis is an uncommon entity, ventricular tachyarrhythmias as the first presenting symptom are very rare.We discuss the case of a 41-year-old Asian woman who presented to our hospital with intermittent palpitation and on evaluation was diagnosed to have systemic sarcoidosis with cardiac involvement.She was started on multiple antiarrhythmic drugs and corticosteroids without any satisfactory response.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, All India Institute of Medical Sciences, New Delhi, India. drsanjeevsinha2002@yahoo.com.

ABSTRACT

Introduction: Symptomatic cardiac involvement is seen in less than 5% of all cases of sarcoidosis. Although clinically apparent cardiac sarcoidosis is an uncommon entity, ventricular tachyarrhythmias as the first presenting symptom are very rare.

Case presentation: We discuss the case of a 41-year-old Asian woman who presented to our hospital with intermittent palpitation and on evaluation was diagnosed to have systemic sarcoidosis with cardiac involvement. She was started on multiple antiarrhythmic drugs and corticosteroids without any satisfactory response.

Conclusions: Our case report indicates that sarcoidosis can manifest as ventricular tachycardia without any detectable systemic findings. This makes sarcoidosis an important diagnostic consideration in patients with ventricular tachycardia of unknown origin given the high mortality associated with ventricular tachyarrhythmias.

No MeSH data available.


Related in: MedlinePlus