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Isolated cardiac sarcoidosis: a case report

https://doi.org/10.15829/1560-4071-2024-5897

EDN: IUXVYQ

Abstract

Introduction. Ventricular arrhythmias are a risk factor for sudden cardiac death. Abnormalities of cardiac rhythm and conduction may be the only subjective manifestation of isolated cardiac sarcoidosis, which occurs in 25% of the total number of patients with this disease.

Brief description. We present a case of isolated cardiac sarcoidosis in a young female patient, the main clinical manifestation of which was attacks of palpitations caused by ventricular tachycardia and episodes of cardiogenic shock without a cardiovascular history. Echocardiography and contrast-enhanced cardiac magnetic resonance imaging (MRI) revealed asymmetric left ventricular hypertrophy and focal myocardial masses. Cardiac tumor and sarcoidosis were suspected. The final diagnosis was based on the results of histological and immunohistochemical analysis of endomyocardial biopsies documenting sarcoidosis. No systemic manifestations of sarcoidosis were found.

Discussion. The case demonstrates the potential of a comprehensive paraclinical study in the diagnosis of cardiac sarcoidosis and its differential diagnosis with other cardiac pathologies.

Conclusion. Cardiac sarcoidosis is difficult to diagnose and requires histological verification in patients with LV hypertrophy and arrhythmias, and physicians should be aware about this rare disease with unfavorable prognosis without specific treatment.

About the Authors

I. A. Skomkina
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation

Irina A. Skomkina — Research assistant of Department of Hypertension

Tomsk



V. F. Mordovin
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation

Victor F. Mordovin — Doctor of Medical Sciences, Professor. Leading researcher of Department of Hypertension

Tomsk



S. V. Triss
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation

Sergey V. Triss — Candidate of Medical Sciences.  Head of Department of Cardiology No. 3

Tomsk



I. V. Stepanov
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation

Ivan V. Stepanov — Candidate of Medical Sciences. Head of Pathoanatomical Department

Tomsk



N. I. Ryumshina
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation

Nadezhda I. Ryumshina — Candidate of Medical Sciences. Researcher of Radiology Department

Tomsk



M. A. Polyakova
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation

Marina A. Polyakova — Deputy Chief Physician for Organizational Work and Medical Services

Tomsk



R. E. Batalov
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation

Tomsk



A. Yu. Falkovskaya
Cardiology Research Institute, Tomsk National Research Medical Center
Russian Federation

Alla Yu. Falkovskaya — Doctor of Medical Sciences. Head of Department of Hypertension

Tomsk



References

1. Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022;43(40):3997-4126. doi:10.1093/eurheartj/ehac262.

2. Lebedev DS, Mikhailov EN, Neminuschiy NM, et al. Ventricular arrhythmias. Ventricular tachycardias and sudden cardiac death. 2020 Clinical guidelines. Russian Journal of Cardiology. 2021;26(7):4600. (In Russ.) doi:10.15829/1560-4071-2021-4600.

3. Lemay S, Massot M, Philippon F, et al. Ten questions cardiologists should be able to answer about cardiac sarcoidosis: case-based approach and contemporary review. CJC Open. 2020;3(4):532-48. doi:10.1016/j.cjco.2020.11.022.

4. Trisvetova EL, Yudina OA, Smolensky AZ, et al. Diagnosis of isolated cardiac sarcoidosis. Arkhiv patologii. 2019;81(1):57-64. (In Russ.) doi:10.17116/patol20198101157.

5. Kupari M, Lehtonen J.Point: should isolated cardiac sarcoidosis be considered a significant manifestation of sarcoidosis? Yes. Chest. 2021;160(1):36-8. doi:10.1016/j.chest.2020.12.037.

6. Moiseeva OM, Mikhailov EN, Mitrofanova LB, et al. Isolated sarcoidosis of the heart: clinical case and literary review. Russian Journal of Cardiology. 2016;(1):99-104. (In Russ.) doi:10.15829/1560-4071-2016-1-99-104.

7. Serova MV, Poltavskaya MG, Garmash YuYu, et al. Complete atrioventricular block as a clinical manifestation of cardiac sarcoidosis. Russian Journal of Cardiology. 2019;(11):63-8. (In Russ.) doi:10.15829/1560-4071-2019-11-63-68.

8. Terasaki F, Azuma A, Anzai T, et al. JCS 2016 Guideline on diagnosis and treatment of cardiac sarcoidosis — digest version. Circ J. 2019;83(11):2329-88. doi:10.1253/circj.CJ-19-0508.

9. Lehtonen J, Uusitalo V, Pöyhönen P, et al. Cardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis. Eur Heart J. 2023;44(17):1495-510. doi:10.1093/eurheartj/ehad067.

10. Evlampieva LG, Yaroslavskaya EI. Sarcoidosis in Actual Clinical Practice. Siberian Medical Journal. 2018;33(3):17-21. (In Russ.) doi:10.29001/2073-8552-2018-33-3-17-21.

11. Terasaki F, Kuwabara H, Takeda Y, et al. Clinical features and histopathology of cardiac sarcoidosis with refractory heart failure: an autopsy case. Intern Med. 2019;58(24):3551- 5. doi:10.2169/internalmedicine.3147-19.

12. Nagai T, Nagano N, Sugano Y, et al. Effect of corticosteroid therapy on long-term clinical outcome and left ventricular function in patients with cardiac sarcoidosis. Circ J. 2015;79(7):1593-600. doi:10.1253/circj.CJ-14-1275.


Supplementary files

  • A case demonstrates the importance of a compre­hensive approach to examination in patients with cardiac arrhythmias.
  • Careful examination with magnetic resonance imaging and endomyocardial biopsy revealed iso­lated cardiac sarcoidosis.

Review

For citations:


Skomkina I.A., Mordovin V.F., Triss S.V., Stepanov I.V., Ryumshina N.I., Polyakova M.A., Batalov R.E., Falkovskaya A.Yu. Isolated cardiac sarcoidosis: a case report. Russian Journal of Cardiology. 2024;29(2S):5897. (In Russ.) https://doi.org/10.15829/1560-4071-2024-5897. EDN: IUXVYQ

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ISSN 1560-4071 (Print)
ISSN 2618-7620 (Online)