Sejben István, Som Zoltán, Cserni Gábor
Patológiai Osztály, Bács-Kiskun Megyei Kórház Kecskemét, Nyíri út 38., 6000.
Felnőtt Kardiológiai Osztály, Gottsegen György Országos Kardiológiai Intézet Budapest.
Orv Hetil. 2017 Jul;158(27):1067-1070. doi: 10.1556/650.2017.30724.
Sarcoidosis is a systemic granulomatous disease of unknown aetiology, which is characterized by bilateral hilar lymphadenopathy and pulmonary disease. Clinically detected cardiac involvement occurs in 5% of sarcoid patients, although cardiac manifestations are discovered in 25% of the cases at autopsy. Sarcoid heart disease frequently causes atrioventricular block. The authors present the case of a 44-year-old man with bradycardia. On admission, second degree Mobitz II, then third degree atrioventricular block was diagnosed. Coronarography showed normal coronary arteries. 2.5 years following artificial Biotronik Entovis DR type pacemaker implantation, sudden cardiac death occurred. Autopsy revealed sarcoidosis with cardiac, pulmonary, splenic, renal and lymph node involvement. In case of young or middle-aged patients with atrioventricular block, it is best to search for other causes if the most common coronary origin can be excluded. Orv Hetil. 2017; 158(27): 1067-1070.
结节病是一种病因不明的全身性肉芽肿性疾病,其特征为双侧肺门淋巴结肿大和肺部病变。临床上,5%的结节病患者会出现心脏受累,不过尸检发现25%的病例存在心脏表现。结节性心脏病常导致房室传导阻滞。作者报告了一例44岁的心动过缓男性病例。入院时诊断为二度莫氏Ⅱ型房室传导阻滞,随后进展为三度房室传导阻滞。冠状动脉造影显示冠状动脉正常。在植入人工百多力Entovis DR型起搏器2.5年后,患者发生心源性猝死。尸检发现结节病累及心脏、肺、脾、肾和淋巴结。对于患有房室传导阻滞的中青年患者,如果可以排除最常见的冠状动脉病因,最好寻找其他病因。《匈牙利医学周报》。2017年;158(27):1067 - 1070。