PMID- 31660477
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220411
IS  - 2514-2119 (Electronic)
IS  - 2514-2119 (Linking)
VI  - 3
IP  - 3
DP  - 2019 Sep
TI  - Natural evolution of cardiac sarcoidosis in an asymptomatic patient: a case 
      report.
PG  - ytz099
LID - 10.1093/ehjcr/ytz099 [doi]
LID - ytz099
AB  - BACKGROUND: Sarcoidosis is a multi-organ granulomatous disease of unknown 
      aetiology. Adverse outcome related with cardiac involvement, makes early 
      diagnosis of cardiac sarcoidosis crucial. CASE SUMMARY: In a 55-year-old man 
      presenting with recurrent pulmonary infections, computed tomography (CT) showed 
      several enlarged mediastinal lymph nodes and no lung pathology. Subsequent 
      mediastinoscopy revealed the diagnosis of sarcoidosis. Further screening for 
      organ involvement showed multifocal cardiac involvement both on cardiac magnetic 
      resonance (CMR) and 18-F-fluorodeoxyglucose-positron emission tomography-computed 
      tomography ((18)F-FDG PET-CT). Because of the lack of functional deterioration 
      and clinical symptoms, no steroid treatment was initiated and regular follow-up 
      of cardiac abnormalities was performed by CMR. Unremarkable progression of 
      cardiac involvement during the first 2 years of follow-up turned into a dramatic 
      involvement after 4 years, with the increase in the number and size of lesions at 
      late gadolinium enhancement (LGE) CMR. Late gadolinium enhancement areas matched 
      the regions of strongly increased (18)F-FDG uptake. For the first time, the 
      patient started complaining on shortness of breath, electrocardiography showed an 
      atrioventricular block Grade 1. Cardiac biomarkers and cardiac function were 
      still preserved. Steroid treatment was started. Although an electrophysiology 
      study was negative, Holter monitoring showed ventricular arrhythmia. 
      Cardioverter-defibrillator was implanted. DISCUSSION: This case shows the 
      progression of cardiac sarcoidosis on CMR in an asymptomatic untreated patient 
      over a 4-year period, and rises the awareness of possible severe cardiac damage 
      even in the absence of clinical signs of cardiac involvement. Combination of PET 
      and CMR is appealing to better understand the evolution of cardiac sarcoidosis 
      and may help in the management of such patients.
CI  - (c) The Author(s) 2019. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Degtiarova, Ganna
AU  - Degtiarova G
AUID- ORCID: 0000-0001-8525-0938
AD  - Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Leuven, 
      Belgium.
FAU - Gheysens, Olivier
AU  - Gheysens O
AD  - Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Leuven, 
      Belgium.
FAU - Van Cleemput, Johan
AU  - Van Cleemput J
AD  - Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
FAU - Wuyts, Wim
AU  - Wuyts W
AD  - Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.
FAU - Bogaert, Jan
AU  - Bogaert J
AUID- ORCID: 0000-0001-7495-9183
AD  - Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, 
      Belgium.
LA  - eng
PT  - Case Reports
DEP - 20190705
PL  - England
TA  - Eur Heart J Case Rep
JT  - European heart journal. Case reports
JID - 101730741
PMC - PMC6764548
OTO - NOTNLM
OT  - 18F-FDG
OT  - CMR
OT  - Cardiac sarcoidosis
OT  - Case report
OT  - PET-CT
EDAT- 2019/10/30 06:00
MHDA- 2019/10/30 06:01
PMCR- 2019/07/05
CRDT- 2019/10/30 06:00
PHST- 2019/01/14 00:00 [received]
PHST- 2019/02/20 00:00 [revised]
PHST- 2019/06/05 00:00 [accepted]
PHST- 2019/10/30 06:00 [entrez]
PHST- 2019/10/30 06:00 [pubmed]
PHST- 2019/10/30 06:01 [medline]
PHST- 2019/07/05 00:00 [pmc-release]
AID - ytz099 [pii]
AID - 10.1093/ehjcr/ytz099 [doi]
PST - epublish
SO  - Eur Heart J Case Rep. 2019 Jul 5;3(3):ytz099. doi: 10.1093/ehjcr/ytz099. 
      eCollection 2019 Sep.