De novo cardiac sarcoidosis presenting as heart failure and resistant ventricular tachycardia": A case report

Sarcoidosis is a multisystem granulomatous disorder that can involve any organ, most commonly the lungs. However, a minority of the patients (8%) presents with extrapulmonary disease that spares the lungs. Although clinically significant cardiac sarcoidosis is a rare occurrence in the absence of lung involvement, it is associated with life-threatening complications. We present a case of de novo cardiac sarcoidosis. The patient presented with symptoms of heart failure and resistant ventricular tachycardia. Fortunately, he responded well to anti-failure medications. Ventricular tachycardia subsided only after starting steroids. Further follow-up was not possible as the patient returned to his home country. Our report highlights the importance of considering cardiac sarcoidosis as a differential diagnosis in patients who present with unexplained heart failure and arrhythmias. • A rare case of fulminant de novo cardiac sarcoidosis presenting with acute heart failure and resistant tachyarrhythmia. • Unusual cardiac wall involvement confirmed by 18F-FDG PET scan. • Clinically isolated cardiac sarcoidosis with no pulmonary involvement. • Marked clinical improvement following initiation of corticosteroid therapy. • Highlights the need to consider cardiac sarcoidosis in patients with unexplained acute heart failure and refractory tachyarrhythmias.