Cardiac sarcoidosis with complete metabolic response and resolution of left ventricular dysfunction complicated by subsequent VT storm.

Sarcoidosis is a multisystem granulomatous disease of unknown aetiology that involves primarily the lungs and lymph nodes. Cardiac involvement is less common but associated with a poorer prognosis. With contemporary diagnostic modalities such as cardiac magnetic resonance and fluorine-18-fluoro-deoxy-glucose positron emission tomography computed tomography, cardiac involvement in sarcoidosis is increasingly diagnosed with appropriate therapy improving outcomes. Although steroid therapy may be protective or therapeutic in preventing left ventricular scarring and preserving LV function, it may not be as effective in the late stages of disease. (Chiu et al in Am J Cardiol 95:143-146, 2005) We present a case of cardiac sarcoidosis with significantly impaired ejection fraction that was diagnosed late in the course of disease with complete metabolic response to therapy and an improvement of LV function, but with a subsequent complication of ventricular tachycardia storm.