Cardiac sarcoidosis

Case contributed by Tim Luijkx
Diagnosis almost certain

Presentation

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

Patient Data

Age: 25
Gender: Male
mri

Patient characteristics:

LV function: EF 35%, SV 92 ml, EDV 265 ml (125 ml/m²), ESV 173 ml (82 ml/m²)

Mitral valve: normal bifasic flow and E/A ratio, stroke volume 86 ml, peak velocity 0.6 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.

Conclusion:

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