Heart block: a primary manifestation of sarcoidosis

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
Ronak RajaniAzad Ghuran

Abstract

We present the case of a 55-year-old male who presented with symptoms of dyspnoea and pre-syncope. A 12 lead electrocardiogram demonstrated extensive conduction abnormalities with 2:1 heart block, right bundle branch block and a small Q wave in lead V(1.) This indicated significant myocardial and septal involvement. Echocardiography confirmed the presence of right ventricular infiltration and dysfunction whilst cardiac magnetic resonance showed the infiltration to be nodular in nature. Although a diagnosis of cardiac sarcoidosis and lymphoma were initially considered, sarcoidosis was eventually confirmed following a cervical lymph node biopsy. This case firstly demonstrates the usefulness of the 12-lead electrocardiogram in determining the likely anatomical locality of significant bradyarrhythmias. Secondly it highlights the difficulties in diagnosing cardiac sarcoidosis when cardiac dysfunction is the sole manifestation of the disease.

References

Apr 24, 1997·The New England Journal of Medicine·L S NewmanL A Maier
Nov 13, 2001·The American Journal of Cardiology·Y YazakiUNKNOWN Central Japan Heart Study Group

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Citations

Dec 22, 2011·Current Opinion in Cardiology·Pablo B NeryDavid H Birnie
Mar 8, 2014·Journal of Cardiovascular Electrophysiology·Pablo B NeryDavid H Birnie

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