JACC. Case reports · 2025
Predominant Right Ventricular Dysfunction in Cardiac Sarcoidosis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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LaLoggia Michael, Jhawar Nikita, Nakhoul Charbel, Kumar Anupam, Wang Harry
Аннотация
BACKGROUND: Clinically significant cardiac sarcoidosis is rare, seen in 5% of patients with sarcoidosis. Predominant right ventricular (RV) dysfunction is seen even less often.
CASE SUMMARY: A 59-year-old man presented to the emergency department from his outpatient cardiologist's office with high-grade atrioventricular block and signs of right-sided heart failure. Transthoracic echocardiogram showed normal left ventricular systolic function, with severe RV enlargement and dysfunction. Right heart catheterization revealed mild postcapillary pulmonary hypertension and disproportionate RV dysfunction. A transbronchial biopsy of mediastinal lymph nodes showed noncaseating granulomas, consistent with sarcoidosis.
DISCUSSION: RV dysfunction in sarcoidosis is most often secondary to lung disease or left heart disease. In general, RV systolic dysfunction is associated with higher all-cause mortality in patients with sarcoidosis.
TAKE-HOME MESSAGE: In patients with cardiac sarcoidosis and predominant RV dysfunction, clinical context along with multimodal imaging, particularly cardiac magnetic resonance imaging, can be useful to reach a diagnosis and provide prognostic value.
CASE SUMMARY: A 59-year-old man presented to the emergency department from his outpatient cardiologist's office with high-grade atrioventricular block and signs of right-sided heart failure. Transthoracic echocardiogram showed normal left ventricular systolic function, with severe RV enlargement and dysfunction. Right heart catheterization revealed mild postcapillary pulmonary hypertension and disproportionate RV dysfunction. A transbronchial biopsy of mediastinal lymph nodes showed noncaseating granulomas, consistent with sarcoidosis.
DISCUSSION: RV dysfunction in sarcoidosis is most often secondary to lung disease or left heart disease. In general, RV systolic dysfunction is associated with higher all-cause mortality in patients with sarcoidosis.
TAKE-HOME MESSAGE: In patients with cardiac sarcoidosis and predominant RV dysfunction, clinical context along with multimodal imaging, particularly cardiac magnetic resonance imaging, can be useful to reach a diagnosis and provide prognostic value.