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伪装成心房颤动的结节病:有趣病例讨论及心脏结节病诊断与管理的最新进展

Sarcoidosis Masquerading as Atrial Fibrillation: Interesting Case Discussion as Well as Recent Advances in Diagnosis and Management of Cardiac Sarcoidosis.

作者信息

Curimbaba Jefferson, Pimenta João, Moreira José Marcos, Carla Sousa Rodrigues UlSilvia, Coletta Ester Nei Aparecida, Pereira Carlos A C

机构信息

Coordinator of the Cardiology Clinic, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil.

Director of the Cardiology Service, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil.

出版信息

J Atr Fibrillation. 2012 Dec 16;5(4):533. doi: 10.4022/jafib.533. eCollection 2012 Dec.

Abstract

This report presents a case of cardiac sarcoidosis initially manifested with atrial fibrillation. This behavior is very uncommon in spite of the fact that the disease is multisystemic, affecting predominantly the lungs. It is emphasized that the diagnosis of the cardiac involvement is difficult, and when this occurs, can lead to conducting system disturbances, heart failure or sudden death (SD). The diagnosis can be made by evaluating the clinical manifestations, the noninvasive tests like ECG, Holter monitoring, chest radiography, thoracic computed tomography, magnetic resonance image and positron emission tomography. In general, sarcoidosis is treated with steroid compounds with good outcome, mainly when performed in the initial phases of the disease. Other cardiac manifestations, such as arrhythmias, atrioventricular block or heart failure, are managed similar to other cardiomyopathies.

摘要

本报告介绍了一例最初表现为心房颤动的心脏结节病病例。尽管该疾病是多系统的,主要影响肺部,但这种表现非常罕见。需要强调的是,心脏受累的诊断很困难,一旦发生,可能导致传导系统紊乱、心力衰竭或猝死(SD)。诊断可通过评估临床表现、心电图、动态心电图监测、胸部X线摄影、胸部计算机断层扫描、磁共振成像和正电子发射断层扫描等无创检查来进行。一般来说,结节病主要在疾病的初始阶段使用类固醇化合物进行治疗,效果良好。其他心脏表现,如心律失常、房室传导阻滞或心力衰竭,其治疗方法与其他心肌病相似。

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