Cardiac sarcoidosis presenting as constrictive pericarditis

In patients with cardiac sarcoidosis, the sarcoid granulomas usually involve the myocardium or endocardium. The disease typically presents as heart failure with ventricular arrhythmias, conduction disturbances, or both. Constrictive pericarditis has rarely been described in patients with sarcoidosis...

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Bibliographic Details
Published in:Texas Heart Institute journal 2014-06, Vol.41 (3), p.319-323
Main Authors: Darda, Saba, Zughaib, Marcel E, Alexander, Patrick B, Machado, Christian E, David, Shukri W, Saba, Souheil
Format: Article
Language:English
Subjects:
Biopsy
Cardiac Catheterization
Cardiomyopathies - complications
Cardiomyopathies - diagnosis
Cardiomyopathies - physiopathology
Cardiomyopathies - surgery
Case Reports
Hemodynamics
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Pericardiectomy
Pericarditis, Constrictive - diagnosis
Pericarditis, Constrictive - etiology
Pericarditis, Constrictive - physiopathology
Pericarditis, Constrictive - surgery
Pleural Effusion - etiology
Predictive Value of Tests
Recovery of Function
Recurrence
Sarcoidosis - complications
Sarcoidosis - diagnosis
Sarcoidosis - physiopathology
Sarcoidosis - surgery
Treatment Outcome
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Summary:In patients with cardiac sarcoidosis, the sarcoid granulomas usually involve the myocardium or endocardium. The disease typically presents as heart failure with ventricular arrhythmias, conduction disturbances, or both. Constrictive pericarditis has rarely been described in patients with sarcoidosis: we found only 2 reports of this association. We report the case of a 57-year-old man who presented with clinical and hemodynamic features of constrictive pericarditis, of unclear cause. He was admitted for treatment of recurrent pleural effusion. After a complicated hospital course, he underwent pericardiectomy. His clinical and hemodynamic conditions improved substantially, and he was discharged from the hospital in good condition. The pathologic findings, the patient's clinical course, and his response to pericardiectomy led to our diagnosis of cardiac sarcoidosis presenting as constrictive pericarditis. In addition to the patient's case, we discuss the nature and diagnostic challenges of cardiac sarcoidosis. Increased awareness of this disease is necessary for its early detection, appropriate management, and potential cure.
ISSN:0730-2347
1526-6702
DOI:10.14503/THIJ-13-3208