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Palpitations as a presenting feature of multisystem sarcoidosis
Journal article   Open access   Peer reviewed

Palpitations as a presenting feature of multisystem sarcoidosis

Richie Manikat, Julieta Gilson, Mahesh Krishnamurthy and Koroush Khalighi
Journal of community hospital internal medicine perspectives, v 7(3), pp 190-193
03 Jul 2017
PMID: 28808515
url
https://doi.org/10.1080/20009666.2017.1333879View
Published, Version of Record (VoR)CC BY-NC V4.0 Open

Abstract

arrhythmias Cardiac sarcoidosis unexplained EKG abnormalities
Introduction: Sarcoidosis is described as a systemic condition characterized by non-caseating granulomas in multiple organs. In this report, we present an unusual manifestation of cardiac sarcoidosis and review management strategies. Case presentation: A 29-year-old African-American man presented with weight loss, fatigue, dyspnea, palpitations, night sweats, painless left eye redness and bilateral leg pain over the course of three months. His physical exam revealed left conjunctival congestion and bilateral crackles on auscultation. Computerized tomography of the chest showed severe parenchymal disease with bilateral fibrotic bands. Bronchoscopy and transbronchial biopsy revealed noncaseating granulomas and multinucleated giant cells, confirming sarcoidosis. Non-sustained ventricular tachycardia developed. Cardiac MRI showed myocardial delayed gadolinium enhancement. He responded to methotrexate and steroid therapy. An implantable cardioverter-defibrillator was placed. Discussion: Although cardiac sarcoidosis manifests in only 5% of sarcoidosis, autopsy reports indicate subclinical cardiac involvement in up to 30%. There are no established criteria for diagnosis of cardiac sarcoidosis. Conclusion: Early recognition and diagnosis of cardiac sarcoidosis is challenging but vital due to unpredictability and high risk for malignant cardiac involvement. Newer diagnostic imaging modalities have further aided in earlier identification and prevention of sudden cardiac death.

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Web of Science research areas
Cardiac & Cardiovascular Systems
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