Fluschnik N, Lund G, Becher PM, Blankenberg S, Muellerleile K. Fulminant isolated cardiac sarcoidosis with pericardial effusion and acute heart failure: Challenging aspects of diagnosis and treatment. World J Clin Cases 2016; 4(3): 76-80 [PMID: 26989672 DOI: 10.12998/wjcc.v4.i3.76]
Corresponding Author of This Article
Dr. Nina Fluschnik, MD, Master of Elementary Didactics, Department of General and Interventional Cardiology, University Heart Center, Martinistr 52, 20246 Hamburg Eppendorf, Germany. n.fluschnik@uke.de
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 16, 2016; 4(3): 76-80 Published online Mar 16, 2016. doi: 10.12998/wjcc.v4.i3.76
Fulminant isolated cardiac sarcoidosis with pericardial effusion and acute heart failure: Challenging aspects of diagnosis and treatment
Nina Fluschnik, Gunnar Lund, Peter Moritz Becher, Stefan Blankenberg, Kai Muellerleile
Nina Fluschnik, Peter Moritz Becher, Stefan Blankenberg, Kai Muellerleile, Department of General and Interventional Cardiology, University Heart Center, 20246 Hamburg Eppendorf, Germany
Gunnar Lund, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
Author contributions: All authors contributed to the acquisition of data, writing, and revision of this manuscript.
Institutional review board statement: The report complies with the guidelines of the Ethics Boards of the University of Hamburg and of the Physicians’ Chamber of the State of Hamburg (Germany). The patient gave his informed consent to this report.
Informed consent statement: The patient involved in this study gave his verbal informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All authors have no conflict of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Nina Fluschnik, MD, Master of Elementary Didactics, Department of General and Interventional Cardiology, University Heart Center, Martinistr 52, 20246 Hamburg Eppendorf, Germany. n.fluschnik@uke.de
Received: May 17, 2015 Peer-review started: May 24, 2015 First decision: June 24, 2015 Revised: July 8, 2015 Accepted: August 20, 2015 Article in press: August 21, 2015 Published online: March 16, 2016 Processing time: 299 Days and 9.9 Hours
Abstract
This case report illustrates challenging aspects of diagnosis and treatment of isolated sarcoid heart disease (SHD) and the role of cardiovascular magnetic resonance (CMR) imaging. Here, we present a previously healthy 45-year-old man, who was admitted with pericardial effusion and symptoms of acute heart failure. CMR followed by targeted left ventricular endomyocardial biopsy (EMB) revealed the diagnosis of isolated SHD. The combined use of CMR and EMB was crucial in diagnosing SHD. Furthermore, this case report demonstrates the value of CMR for monitoring response to therapy and lesion healing.
Core tip: This case report illustrates the challenging aspects of diagnosis and treatment of isolated sarcoid heart disease (SHD) and the role of cardiac magnetic resonance imaging (CMR) in diagnosis. Due to the use of CMR followed by targeted left ventricular endomyocardial biopsy the diagnosis of isolated SHD could be achieved. Most importantly, this case supports the use of CMR as an extremely useful non-invasive technique for monitoring response to therapy and lesion healing in the course of heart failure.
