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Cardiac sarcoidosis mimicking arrhythmogenic right ventricular dysplasia with high defibrillation threshold requiring subcutaneous shocking coil implantation.
Heart Lung Circ. 2012 Jan; 21(1):46-9.HL

Abstract

Cardiac involvement in patients with sarcoidosis has been reported in up to 25-39% of patients and is responsible for up to 85% of deaths attributed to the disease, often due to sudden cardiac death. An established diagnosis of cardiac sarcoidosis (CS) portends an ominous prognosis, with an estimated five year-survival of 44%. We report a case that was initially diagnosed as arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), but extra-cardiac biopsies later on were consistent with sarcoidosis and a final diagnosis of CS was made. The patient received an implantable cardioverter defibrillator (ICD) with a subcutaneous lead array implant for high defibrillation threshold (DFT). Exclusive right ventricular (RV) involvement is atypical for CS. The predominant RV involvement based on echocardiogram, cardiac magnetic resonance imaging (MRI) and right precordial electrocardiogram changes can lead to misdiagnosis as ARVD/C based on the modified task force criteria. Cardiac sarcoidosis is an under-diagnosed disease and the delay in its diagnosis and appropriate therapy can lead to a fatal outcome. High defibrillation thresholds have not been previously reported in patients with CS, but given the natural progression of the disease and the limitations in current pharmacotherapy, implanters who diagnose and treat such patients must be prepared to deal with this issue.

Authors+Show Affiliations

Department of Medicine, George Washington University Medical Center, 2150 Pennsylvania Avenue, NW Ambulatory Care Center, Suite 5-411 Washington, DC 20037, United States. amr.mohsen@va.govNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21982156

Citation

Mohsen, Amr, et al. "Cardiac Sarcoidosis Mimicking Arrhythmogenic Right Ventricular Dysplasia With High Defibrillation Threshold Requiring Subcutaneous Shocking Coil Implantation." Heart, Lung & Circulation, vol. 21, no. 1, 2012, pp. 46-9.
Mohsen A, Panday M, Wetherold S, et al. Cardiac sarcoidosis mimicking arrhythmogenic right ventricular dysplasia with high defibrillation threshold requiring subcutaneous shocking coil implantation. Heart Lung Circ. 2012;21(1):46-9.
Mohsen, A., Panday, M., Wetherold, S., & Jimenez, A. (2012). Cardiac sarcoidosis mimicking arrhythmogenic right ventricular dysplasia with high defibrillation threshold requiring subcutaneous shocking coil implantation. Heart, Lung & Circulation, 21(1), 46-9. https://doi.org/10.1016/j.hlc.2011.08.013
Mohsen A, et al. Cardiac Sarcoidosis Mimicking Arrhythmogenic Right Ventricular Dysplasia With High Defibrillation Threshold Requiring Subcutaneous Shocking Coil Implantation. Heart Lung Circ. 2012;21(1):46-9. PubMed PMID: 21982156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiac sarcoidosis mimicking arrhythmogenic right ventricular dysplasia with high defibrillation threshold requiring subcutaneous shocking coil implantation. AU - Mohsen,Amr, AU - Panday,Manoj, AU - Wetherold,Suzanne, AU - Jimenez,Alejandro, Y1 - 2011/10/06/ PY - 2010/11/02/received PY - 2011/08/03/revised PY - 2011/08/22/accepted PY - 2011/10/11/entrez PY - 2011/10/11/pubmed PY - 2012/4/17/medline SP - 46 EP - 9 JF - Heart, lung & circulation JO - Heart Lung Circ VL - 21 IS - 1 N2 - Cardiac involvement in patients with sarcoidosis has been reported in up to 25-39% of patients and is responsible for up to 85% of deaths attributed to the disease, often due to sudden cardiac death. An established diagnosis of cardiac sarcoidosis (CS) portends an ominous prognosis, with an estimated five year-survival of 44%. We report a case that was initially diagnosed as arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), but extra-cardiac biopsies later on were consistent with sarcoidosis and a final diagnosis of CS was made. The patient received an implantable cardioverter defibrillator (ICD) with a subcutaneous lead array implant for high defibrillation threshold (DFT). Exclusive right ventricular (RV) involvement is atypical for CS. The predominant RV involvement based on echocardiogram, cardiac magnetic resonance imaging (MRI) and right precordial electrocardiogram changes can lead to misdiagnosis as ARVD/C based on the modified task force criteria. Cardiac sarcoidosis is an under-diagnosed disease and the delay in its diagnosis and appropriate therapy can lead to a fatal outcome. High defibrillation thresholds have not been previously reported in patients with CS, but given the natural progression of the disease and the limitations in current pharmacotherapy, implanters who diagnose and treat such patients must be prepared to deal with this issue. SN - 1444-2892 UR - https://www.unboundmedicine.com/medline/citation/21982156/Cardiac_sarcoidosis_mimicking_arrhythmogenic_right_ventricular_dysplasia_with_high_defibrillation_threshold_requiring_subcutaneous_shocking_coil_implantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1443-9506(11)01094-8 DB - PRIME DP - Unbound Medicine ER -