Cardiac sarcoidosis

Case contributed by Dr Tim Luijkx


No symptoms. Employment-related medical check-up revealed abnormal ECG and dilated left ventricle.

Patient Data

Age: 25
Gender: Male

Patient characteristics:
Dimensions: LV 62 mm, RV 39 mm, septum 11 mm

LV function: EF 35%, SV 92 ml, EDV 265 ml (125 ml/m²), ESV 173 ml (82 ml/m²)
RV function: EF 47%, SV 97 ml, EDV 208 ml (98 ml/m²), ESV 111 ml (52 ml/m²)

Mitral valve: normal bifasic flow and E/A ratio, stroke volume 86 ml, peak velocity 0.6 m/sec.
Aortic valve: tricuspid valve, stroke volume 94 ml, peak velocity 1.2 m/sec.

Global hypokinesia of left ventricle, most prominent in several focal areas of thinned ventricular wall and late enhancement. There is extensive late enhancement in a non-ischemic pattern:

  • mid-wall of the interventricular septum
  • epicardial in the anterior, anterolateral and inferior LV wall
  • superior portion of (lateral) papillary muscles.
  • inferior RV wall 
  • RV outflow tract

There is also slight RV hypokinesia without focal akinesia or dyskinesia. No lymphadenopathy or other gross abnormalities visible on survery images.

Dilated LV with poor function (ejection fraction 35%). Extensive late enhancement in a non-ischemic pattern, most pronounced in LV, but also in RV. Images most consistent with sarcoidosis. Differential diagnosis includes (status after) extensive myocarditis or other cardiomyopathy.

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Case information

rID: 39811
Published: 28th Sep 2015
Last edited: 14th Aug 2019
System: Cardiac
Inclusion in quiz mode: Included

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