Primary Cardiac Sarcoidosis with Syncope and Refractory Atrial Arrhythmia: A Case Report and Review of the Literature

被引：4

作者：

Thangam, Manoj ^{[1
]}

Nathan, Sriram ^{[1
]}

Kar, Biswajit ^{[1
]}

Petrovic, Marija ^{[1
]}

Patel, Manish ^{[1
]}

Loyalka, Pranav ^{[1
]}

Buja, L. Maximilian ^{[2
]}

Gregoric, Igor D. ^{[1
]}

机构：

[1] Univ Texas Hlth Sci Ctr Houston, Mem Hermann Hosp, Texas Med Ctr, Ctr Adv Heart Failure, Houston, TX 77030 USA

[2] Univ Texas Hlth Sci Ctr Houston, Mem Hermann Hosp, Texas Med Ctr, Dept Pathol & Lab Med, Houston, TX 77030 USA

来源：

TEXAS HEART INSTITUTE JOURNAL | 2016年 / 43卷 / 03期

关键词：

Atrial fibrillation; fibrosis; granuloma/pathology; sarcoidosis; cardiac/diagnosis/etiology/epidemiology/therapy/pathology; MYOCARDITIS; MANAGEMENT; DIAGNOSIS; AUTOPSY; MASS;

D O I：

10.14503/THIJ-14-4792

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We discuss the case of a 38-year-old black man who presented at our hospital with his first episode of syncope, recently developed atrial arrhythmias refractory to pharmacologic therapy, and a left atrial thrombus. He was diagnosed with primary cardiac sarcoidosis characterized by predominant involvement of the epicardium that caused atrial fibrillation and atrial flutter. Histologic analysis of his epicardial lesions yielded a diagnosis of sarcoidosis. This patient's atrial arrhythmia was successfully treated with a hybrid operation that involved resection of his atrial appendage, an Epicor maze procedure, and radiofrequency ablation during a catheter-based electrophysiologic study. The cardiac sarcoidosis was successfully managed with corticosteroid therapy. Our case report shows that sarcoidosis can initially manifest itself as syncope with new-onset atrial arrhythmia. Sarcoidosis is important in the differential diagnosis because of its progressive nature and its potential for treatment with pharmacologic, surgical, and catheter-based interventions.

引用

页码：236 / 240

页数：5