Abstrait

Role of echocardiography in suspicion of cardiac sarcoidosis: A case of cardiac sarcodiosis

Amr Elhusseni

Sarcoidosis is a multi-organ granulomatous disease of unknown aetiology. Adverse outcome related with cardiac in-volvement, makes early diagnosis of cardiac sarcoidosis crucial. In a 60-year-old man presenting with epigastric pain, echocardiography showed thinned out basal inferior sptum and basal inferior wall. Further screening for sarcoidosis involvement showed multifocal cardiac involvement both on cardiac magnetic resonance (CMR) and 18-F-fluorothymidine -positron emission tomography-computed tomography (F18-FLT PET-CT). Because of the functional deterioration and clinical symptoms, steroid treatment was initiated and regular follow-up of cardiac abnormalities. This case shows the finding of cardiac sarcoidosis on echocardiogram in symptomatic untreated patient, and rises the awareness of possible severe cardiac damage, Combination of PET and CMR is appealing to better understand the evolution of cardiac sarcoidosis and may help in the management of such patients. The echocardiogram is often abnormal in manifest cardiac sarcodiosis (CS) disease, but is usually normal in clinically silent CS (1). Abnormalities are variable and usually nonspecific, although interventricular septal thinning, especially basal, can be a feature of CS (2). Less frequently, there may be an increase in myocardial wall thickness, simulating left ventricular (LV) hypertrophy or resembling hypertrophic cardiomyopathy (3). Other abnormalities include LV and/or RV diastolic and systolic dysfunction, isolated wall motion abnormalities, basal septal thinning, and aneurysms (4, 5). Regional wall motion abnormalities are usually seen in a non-coronary distribution.