Jmeian Ashraf, Thawabi Mohammad, Goldfarb Irvin, Shamoon Fayez
Department of Cardiology, Saint Michael's Medical Center, Newark, New Jersey, USA.
N Am J Med Sci. 2015 Mar;7(3):114-8. doi: 10.4103/1947-2714.153923.
Cardiac sarcoidosis (CS) is a rare, potentially fatal disease. It has a wide range of clinical presentations that range from asymptomatic electrocardiogram changes to sudden cardiac death. Ventricular aneurysms and ventricular tachycardia are seen late in the disease, and are rarely the presenting manifestation of the disease. Diagnosis of CS is challenging and often missed or delayed.
We report a 35-year-old patient who presented with sustained ventricular tachycardia and ST-elevation on electrocardiogram. Cardiac catheterization showed normal coronaries and left ventricular aneurysm. Subsequent 2D-echocardiography showed an infiltrative disease pattern. Cardiac MRI was done and showed late gadolinium enhancement in the septum, apex and lateral wall. The patient was diagnosed with cardiac sarcoidosis and treated with immune suppression and antiarrhythmic agent. In addition underwent AICD implantation.
Our case highlights the importance of suspecting cardiac sarcoidosis in young patients presenting with electrocardiogram changes, and present an atypical presentation of this disease.
心脏结节病（CS）是一种罕见的、潜在致命的疾病。它有广泛的临床表现，从无症状的心电图改变到心源性猝死。室壁瘤和室性心动过速在疾病晚期出现，很少是该疾病的首发表现。CS的诊断具有挑战性，常常被漏诊或延误。
我们报告一名35岁患者，其表现为持续性室性心动过速和心电图ST段抬高。心脏导管检查显示冠状动脉正常及左心室室壁瘤。随后的二维超声心动图显示为浸润性疾病模式。进行了心脏磁共振成像检查，结果显示在室间隔、心尖和侧壁有钆延迟强化。该患者被诊断为心脏结节病，并接受了免疫抑制和抗心律失常药物治疗。此外还接受了植入式心律转复除颤器（AICD）植入术。
我们的病例强调了对于出现心电图改变的年轻患者怀疑心脏结节病的重要性，并展示了该疾病的一种非典型表现。
