Swain William, Castrichini Matteo, Siontis Konstantinos, Hasan Fadi, Arment Courtney
Department of Internal Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
Department of Cardiovascular Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
Eur Heart J Case Rep. 2024 Oct 23;8(11):ytae557. doi: 10.1093/ehjcr/ytae557. eCollection 2024 Nov.
Sarcoidosis is a disease characterized by non-caseating granulomas and may affect any organ system. Cardiac involvement may lead to conduction abnormalities, heart failure, or malignant ventricular arrhythmias. As sarcoidosis may present with heterogeneous manifestations, a detailed past medical history may provide clues that help guide further workup. We present a rare case of a patient with undiagnosed oral sarcoidosis who subsequently experienced cardiac arrest from cardiac involvement.
A 43-year-old male with a history of palpitations and periodontitis consistent with oral sarcoidosis presents after experiencing sudden cardiac arrest. He was subsequently diagnosed with cardiac and pulmonary sarcoidosis. With contemporary management (both immunosuppression and antiarrhythmics), he has not experienced any recurrent arrhythmias.
In the setting of cardiac arrest and non-ischaemic cardiomyopathy, a careful clinical history and targeted cardiac testing may help clinicians determine when to consider cardiac sarcoidosis as a diagnosis. While oral sarcoidosis is a very rare condition, this case highlights how infrequent manifestations of sarcoidosis may be encountered in the clinical setting.
结节病是一种以非干酪样肉芽肿为特征的疾病,可累及任何器官系统。心脏受累可能导致传导异常、心力衰竭或恶性室性心律失常。由于结节病可能表现出异质性,详细的既往病史可能提供有助于指导进一步检查的线索。我们报告一例罕见病例,一名未被诊断出患有口腔结节病的患者随后因心脏受累而发生心脏骤停。
一名43岁男性,有与口腔结节病相符的心悸和牙周炎病史,在经历心脏骤停后前来就诊。他随后被诊断为心脏和肺部结节病。通过当代治疗(免疫抑制和抗心律失常药物),他未再出现任何心律失常。
在心脏骤停和非缺血性心肌病的情况下,仔细的临床病史和针对性的心脏检查可能有助于临床医生确定何时考虑将心脏结节病作为诊断。虽然口腔结节病是一种非常罕见的疾病,但该病例突出了在临床环境中可能遇到结节病的罕见表现。