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• W2041506539 abstract "Sarcoidosis is a systemic disease characterized by noncaseating granulomas. Cardiac involvement is generally underdiagnosed, and affects disease prognosis. Cardiac manifestations typically include brady and tachyarrhythmias, cardiac dilation and dysfunction leading to heart failure [ [1] Isobe Mitsuaki Tezuka Daisuke Isolated cardiac sarcoidosis: clinical characteristics, diagnosis and treatment. Int. J. Cardiol. 2015; 182: 132-140 Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar ]. Aneurysm formation in left and right ventricular walls has been described as a characteristic feature of the disease and it has been linked to prognosis in a recent Letter to the Editor appeared in the Journal [ [2] Miyazawa Kazuo Yoshikawa Tsutomu Takamisawa Itaru et al. Presence of ventricular aneurysm predicts poor clinical outcomes in patients with cardiac sarcoidosis. Int. J. Cardiol. 2014; 177: 720-722 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar ]. Cardiac involvement can be part of systemic disease and also present in isolated form [ [1] Isobe Mitsuaki Tezuka Daisuke Isolated cardiac sarcoidosis: clinical characteristics, diagnosis and treatment. Int. J. Cardiol. 2015; 182: 132-140 Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar ]. Here, we report the emblematic case of a 39 year-old Caucasian female patient, with unremarkable past medical history, who was admitted to our Cardiology Unit for symptomatic complex ventricular arrhythmias. Cardiac magnetic resonance (CMR) cine images (Supplementary Videos 1 and 2) and late gadolinium enhancement (LGE) (Fig. 1, Panels A and B) showed an aneurysm of the anterior basal wall of the left ventricle without signs of oedema on T2-weighted images (Fig. 1, Panel C) and with normal biventricular function. Coronary angiogram was normal; left ventriculography showed basal anterior aneurysm with evidence of wall thinning (Fig. 1, Panels D–F). Symptomatic ventricular complex arrhythmias persisted despite therapy with beta-blockers and amiodarone. Surgical aneurysmectomy was performed. Histologic examination revealed granulomatous disease characteristic of sarcoidosis (Fig. 2, Panels A and B). The patient underwent total body fluorodeoxyglucose-positron emission tomography (FDG-PET), which highlighted disease activity in the thoracic and abdominal cavities (Fig. 2, Panels C and D). Corticosteroids were started (prednisone 25 mg/day). After surgery the patient was admitted to a post-cardiac surgery rehabilitation center; prolonged ECG telemetry was unremarkable. Follow-up CMR revealed good result of the surgical intervention, no signs of disease activity and normal biventricular function; FDG-PET confirmed disease quiescence. Considering normal biventricular function, disease quiescence, absence of significant arrhythmias, and no areas of LGE at follow-up CMR, a part from the area of ventricular patch, a defibrillator was not implanted. Prednisone was tapered to 5 mg/day, and methotrexate was introduced, up to 5 mg/week with foline. Amiodarone was discontinued and bisoprolol 5 mg/day was maintained. The patient is well and asymptomatic after two years from diagnosis." @default.
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• W2041506539 date "2015-05-01" @default.
• W2041506539 modified "2023-10-18" @default.
• W2041506539 title "Ventricular aneurysms in cardiac sarcoidosis: From physiopathology to surgical treatment through a clinical case presenting with ventricular arrhythmias" @default.
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• W2041506539 doi "https://doi.org/10.1016/j.ijcard.2015.03.256" @default.
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