Life threating onset of Cardiac Sarcoidosis with mediastinal involvement

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Marcello Ciuffreda
Valentina Valenti
Giuseppe Manfrè
Antonio Barberi
Patrizia Porzi
Francesco Versaci
Antonella Sarni

Keywords

EBUS TBNA, Acute respiratory failure, Cardiac arrhythmias, Cardiac failure

Abstract

We have described a clinical case with atypical onset of sarcoidosis. A young patient presented to the emergency room with acute heart failure and severe cardiac dysfunction simulating dilated cardiomyopathy or severe myocarditis. Hypoxic respiratory failure refractory to oxygen therapy was treated with steroids. The diagnosis was made by a multidisciplinary team who decided to perform EndoBronchial UltraSound-guided TransBronchial Needle Aspiration (EBUS TBNA) in addition to a cardiac MRI. The result was to obtain, in this case, a prompt therapeutic response in order to preserve the patient cardiac function.


 

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References

1 Birnie DH, Nery PB, et al. Cardiac Sarcoidosis. J Am Coll Cardiol 2016; 68 (4): 411-21.
2 Gilotra NA, Griffin JM, Pavlovic N, et al. Sarcoidosis-Related Cardiomyopathy: Current Knowledge, Challenges, and Future Perspectives State-of-the-Art Review. J Card Fail. 2022 Jan;28(1):113-132. doi: 10.1016/j.cardfail.2021.06.016.
3 Muser D, Santangeli P, et al Characterization of the electroanatomic substrate in cardiac sarcoidosis: correlation with imaging findings of scar and inflammation. JACC Clin Electrophysiol 2018; (4): 291–303.
4 Trisolini R, Baughman R, et al. Endobronchial Ultrasound guided transbronchial needle aspiration in sarcoidosis: beyond the diagnostic yield. Respirology 2019; (24): 531–542.
5 Stevenson A, Bray JJH, Tregidgo L, et al. Prognostic Value of Late Gadolinium Enhancement Detected on Cardiac Magnetic Resonance in Cardiac Sarcoidosis. JACC Cardiovasc Imaging. 2023 Mar;16(3):345-357. doi: 10.1016/j.jcmg.2022.10.018.
6 Blauwet LA, Cooper LT, et al. Idiopathic giant cell myocarditis and cardiac sarcoidosis. Heart Fail Rev. 2013 Nov;18(6):733-46.
7 Nordenswan HK, Lehtonen J, Ekström K, et al. Manifestations and Outcome of Cardiac Sarcoidosis and Idiopathic Giant Cell Myocarditis by 25-Year Nationwide Cohorts. J Am Heart Assoc. 2021 Mar 16;10(6):e019415. doi: 10.1161/JAHA.120.019415.