American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
Open Access
Journal Browser
Go
American Journal of Medical Case Reports. 2015, 3(6), 160-162
DOI: 10.12691/ajmcr-3-6-3
Open AccessCase Report

Isolated Cardiac Sarcoidosis Presenting with Acute Ruptured Chordae

Jonathan Powell1, and Emanuel Ebin1

1Internal Medicine Resident Physician, Florida Atlantic University

Pub. Date: May 15, 2015

Cite this paper:
Jonathan Powell and Emanuel Ebin. Isolated Cardiac Sarcoidosis Presenting with Acute Ruptured Chordae. American Journal of Medical Case Reports. 2015; 3(6):160-162. doi: 10.12691/ajmcr-3-6-3

Abstract

Isolated cardiac sarcoidosis is a rare but life threatening sub classification of sarcoidosis. The symptomology can range from incidental asymptomatic disease to a life threatening disorder causing sudden cardiac death [3]. Conduction disorders are a well documented manifestation of cardiac sarcoid, however a lesser studied yet life threatening problem includes granulomatous involvement of the myocardium leading to heart failure and cord rupture. Early diagnosis and initiation of appropriate treatment are paramount in preventing destruction of myocardial tissue and improving the survival rate of this unique patient population. We present a case of an otherwise healthy young adult male that presented with acute decompensated heart failure with complete bi-valve failure requiring urgent cardiac surgery.

Keywords:
cardiac sarcoidosis acute ruptured chordae acute decompensated congestive heart failure

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Kim JS, Judson MA, Donnino R, et al: Cardiac sarcoidosis. Am Heart J 2009; 157: 9-21.
 
[2]  Sugizaki Y, Tanaka H, Imanishi J, et al: Isolated primary cardiac sarcoidosis presenting as acute heart failure. Intern Med 2013; 52: 71-74.
 
[3]  Yazaki Y: The diagnostic dilemma of isolated cardiac sarcoidosis. Intern Med 2013; 52: 1-2.
 
[4]  White J, Sutton T, Kerr A: Isolated primary cardiac sarcoidosis: MRI diagnosis and monitoring of treatment response with cardiac enzymes. Circ Heart Fail 2010; 3:28-29.
 
[5]  Smedema JP, Snoep G, van Kroonenburgh MP, et al: Evaluation of the accuracy of gadolinium-enhanced cardiovascular magnetic resonance in the diagnosis of cardiac sarcoidosis. J Am CollCardiol 2005; 45: 1683-1690.
 
[6]  Ichinose A, Otani H, Oikawa M, et al: MRI of cardiac sarcoidosis: Basal and subepicardial localization of myocardial lesions and their effect on left ventricular function. Am J Roentgenol 2008; 191: 862-869.
 
[7]  Tahara N, Tahara A, Nitta Y, et al: Heterogeneous myocardial FDG uptake and the disease activity in cardiac sarcoidosis. J Am CollCardiolCardiovasc Imaging 2010; 3:1219-1228.
 
[8]  Yamagishi H, Shirai N, Takagi M, et al: Identification of cardiac sarcoidosis with (13)N NH(3)/(18)F-FDG PET. J Nucl Med 2003;44:1030-1036.
 
[9]  Kaneta T: A brief review of Japanese guidelines for the clinical use of (18)F-FDG-PET/MRI 2012 (Ver 1.0). Ann Nucl Med 2013; 27: 309-313.
 
[10]  Kandolin R, Lehtonen J, Graner M, et al: Diagnosing isolated cardiac sarcoidosis. J Intern Med 2011; 270: 461-468.
 
[11]  Chiu CZ, Nakatani S, Zhang G, et al: Prevention of left ventricular remodeling by long-term corticosteroid therapy in patients with cardiac sarcoidosis. Am J Cardiol2005; 95: 143-146.
 
[12]  Kato Y, Morimoto S, Uemura A, et al: Efficacy of corticosteroids in sarcoidosis presenting with atrioventricular block. Vasc Diffuse Lung Dis 2003; 20: 133-137.
 
[13]  Yodogawa K, Seino Y, Ohara T, et al: Effect of corticosteroid therapy on ventricular arrhythmias in patients with cardiac sarcoidosis. Ann Noninvasive Electrocardiol 2011; 16: 140-147.
 
[14]  Youssef G, Beanlands RS, Birnie DH, et al: Cardiac sarcoidosis: Applications of imaging in diagnosis and directing treatment. Heart 2011; 97: 2078-2087.
 
[15]  Zaidi AR, Zaidi A, Vaitkus PT: Outcome of heart transplantation in patients with sarcoidcardiomyopathy.J Heart Lung Transplant 2007; 26: 714-717.
 
[16]  Sharma OP, Maheshwari A, Thaker K: Myocardial sarcoidosis. Chest 1993; 103: 253-258.
 
[17]  Smedema JP, Snoep G, van Kroonenburgh MP, et al. Evaluation of the accuracy of gadolinium-enhanced cardiovascular magnetic resonance in the diagnosis of cardiac sarcoidosis. J Am CollCardiol. 2005; 45: 1683-90.
 
[18]  Osman F, Foundon A, Leyva P, Pitt M, Murray RG. Early diagnosis of cardiac sarcoidosis usingmagnetic resonance imaging. Int J Cardiol. 2008; 125:e4-5.
 
[19]  Mantini N, Williams B Jr, Stewart J, Rubinsztain L, Kacharava A. Cardiac sarcoid: a clinician’s review on how to approach the patient with cardiac sarcoid. ClinCardiol. 2012; 35: 410-5.