Chasing the ACE of hearts

A case study of a patient presenting with acute pulmonary oedema, dynamic ECG changes and a rise in cardiac biomarkers with no evidence of myocardial infarction. The clinical course followed a dynamic and inflammatory disease process with evidence of sarcoidosis on tissue histology. The patient had...

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Bibliographic Details
Published in:BMJ case reports 2013-06, Vol.2013, p.bcr2013009668
Main Authors: D'Silva, Andrew, Jassim, Imad, Greenwood, John, Grosser, Konrad
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Angiotensin-Converting Enzyme Inhibitors - administration & dosage
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Aspirin - administration & dosage
Aspirin - therapeutic use
Biopsy
Blood pressure
Cardiac arrhythmia
Drug Therapy, Combination
Edema
Ejection fraction
Electrocardiography
Europe (West)
Female
Heart Diseases - diagnosis
Heart Diseases - drug therapy
Heart Diseases - physiopathology
Heart failure
Heparin, Low-Molecular-Weight - administration & dosage
Heparin, Low-Molecular-Weight - therapeutic use
Humans
Lymphatic system
Middle Aged
Rare Disease
Sarcoidosis
Sarcoidosis - diagnosis
Sarcoidosis - drug therapy
Sarcoidosis - physiopathology
Sinuses
Steroids
Ticlopidine - administration & dosage
Ticlopidine - analogs & derivatives
Ticlopidine - therapeutic use
Treatment Outcome
Ultrasonic imaging
White
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Description
Summary:A case study of a patient presenting with acute pulmonary oedema, dynamic ECG changes and a rise in cardiac biomarkers with no evidence of myocardial infarction. The clinical course followed a dynamic and inflammatory disease process with evidence of sarcoidosis on tissue histology. The patient had an excellent clinical response to corticosteroid therapy with minimal evidence of hyperenhancement (focal fibrosis) on cardiac MRI at 6 months. The case highlights the challenges in making a new diagnosis of sarcoidosis where involvement appears limited to the heart and lymphatic system.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2013-009668