Chamorro-Pareja Natalia, Marin-Acevedo Julian A, Chirilă Răzvan M
Division of Pulmonary, Allergy and Sleep Medicine, Mayo Clinic, 4500 San Pablo, Rd, Jacksonville, FL32224, USA.
Division of General Internal Medicine, Mayo Clinic, 4500 San Pablo, Rd, Jacksonville, FL32224, USA.
Rom J Intern Med. 2019 Mar 1;57(1):7-13. doi: 10.2478/rjim-2018-0030.
Cardiac sarcoidosis usually occurs in the context of systemic disease; however, isolated cardiac involvement can occur in up to 25% of cases and tends to be clinically silent. When symptoms are present, they are often nonspecific and occasionally fatal, representing a diagnostic challenge. A high index of clinical suspicion and the integration of appropriate imaging, laboratory, and pathologic findings is always required. Treatment aims to control the systemic inflammatory condition while preventing further cardiac damage. However, even with adequate diagnosis and treatment strategies, prognosis remains poor. We describe the case of a patient who presented with cardiac symptoms, whose initial examination was unrevealing. Diagnosis was made retrospectively based on later systemic manifestations that revealed characteristic sarcoidosis findings.
心脏结节病通常发生在全身性疾病的背景下;然而,孤立性心脏受累在高达25%的病例中可能出现,且往往在临床上无明显症状。当出现症状时,通常是非特异性的,偶尔会致命,这构成了诊断挑战。始终需要高度的临床怀疑以及综合适当的影像学、实验室和病理学检查结果。治疗旨在控制全身性炎症状态,同时防止心脏进一步受损。然而,即使有充分的诊断和治疗策略,预后仍然很差。我们描述了一名出现心脏症状的患者的病例,其初始检查未发现异常。诊断是基于后来出现的全身性表现回顾性做出的,这些表现显示出特征性的结节病表现。