This case report highlights the diagnostic challenge of complete heart block in a young adult, revealing myocardial sarcoidosis alongside rheumatic aortic stenosis at autopsy.
Suggests considering sarcoidosis in young adults with complete heart block and rheumatic aortic stenosis; leaves open broader diagnostic implications.
Case Reports1 October 1959MYOCARDIAL SARCOID, COMPLETE HEART BLOCK AND AORTIC STENOSISROBERT E. BOTTI, M.D., FRANK E. YOUNG, M.D.ROBERT E. BOTTI, M.D., FRANK E. YOUNG, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-51-4-811 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptComplete heart block in a young adult may pose a difficult diagnostic and therapeutic problem. The subject of this case report illustrates these difficulties and is of unusual interest because of the autopsy finding of myocardial sarcoid in addition to the clinically apparent rheumatic heart disease with aortic stenosis.CASE REPORTA 32 year old white female was admitted to University Hospitals of Cleveland on August 8, 1957, having had fainting spells of six months' duration.This patient had been asymptomatic until six months before admission, when she suddenly became unconscious for a few seconds while playing cards. She awoke...Bibliography1. HudsonChobanianRelman JBAVAS: Hypoaldosteronism, New England J. Med. 257: 529, 1957. CrossrefMedlineGoogle Scholar2. TedeschiWagnerPani CGBMDC: Studies in rheumatic fever, Arch. Path. 60: 408, 1955. MedlineGoogle Scholar3. PentonMillerLevine GBHSA: Some clinical features of complete heart block, Circulation 13: 801, 1956. CrossrefMedlineGoogle Scholar4. Place EH: Heart in diphtheria and scarlet fever, New England J. Med. 207: 864, 1932. CrossrefGoogle Scholar5. HoyneWelford ANT: Diphtheritic myocarditis, J. Pediat. 5: 642, 1934. CrossrefGoogle Scholar6. White PD: Acute heart block occurring as the first sign of rheumatic fever, Am. J. M. Sc. 152: 589, 1916. CrossrefGoogle Scholar7. Stern VS: Stokes-Adams attacks in the child, Brit. Heart J. 6: 66, 1944. CrossrefMedlineGoogle Scholar8. WarshawskyAbramson HW: Complete heart block in calcareous aortic stenosis, Ann. Int. Med. 27: 1040, 1947. LinkGoogle Scholar9. Leys DG: Heart block following diphtheria, Brit. Heart J. 7: 57, 1945. CrossrefMedlineGoogle Scholar10. PeacockLippschultzLukas RAEJA: Myocardial sarcoidosis, Circulation 16: 67, 1957. CrossrefMedlineGoogle Scholar11. LongcopeFreiman WTDG: A study of sarcoidosis, Medicine 31: 1, 1952. CrossrefMedlineGoogle Scholar12. YatesLeamanCornell WMWGVH: Congenital heart block; report of third case of complete heart block studied by serial sections through conduction system, J. A. M. A. 102: 1660, 1934. CrossrefGoogle Scholar13. WendkosStudy MHRS: Familial congenital complete A-V heart block, Am. Heart J. 34: 138, 1947. CrossrefMedlineGoogle Scholar14. Lillehei CW, discussion of Kirklin, J. W., Harshbarger, H. G., Donald, D. E., and Edwards, J. E.: Surgical correction of ventricular septal defect: anatomic and technical considerations, J. Thoracic Surg. 33: 45, 1957. CrossrefGoogle Scholar15. Lillehei CW: Present status of open cardiotomy for correction of congenital and acquired cardiac disease, Mod. Concepts Cardiovas. Dis. 27: 441, 1958. MedlineGoogle Scholar16. Nelson CT: Kveim reaction in sarcoidosis, J. Chron. Dis. 6: 158, 1957. CrossrefMedlineGoogle Scholar17. RicherClark WM: Sarcoidosis: a clinical pathologic review of three hundred cases including twenty-two autopsies, Am. J. Clin. Path. 19: 725, 1949. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cleveland, Ohio*Received for publication June 2, 1958.From the Departments of Medicine, University Hospitals and the Institute of Pathology, Western Reserve University, Cleveland, Ohio.†Supported in part by training grant of the U. S. Public Health Service.Requests for reprints should be addressed to Frank E. Young, M.D., Institute of Pathology, Western Reserve University, Cleveland, Ohio. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCardiac sarcoidosis: Diagnostic, prognostic, and therapeutic considerationsAnatomie und pathologische Anatomie des spezifischen Reizbildungs- und Erregungsleitungssystems sowie des kontraktilen MyokardsInfiltrative cardiomyopathy with conduction disease and ventricular arrhythmia: Electrophysiologic and pathologic correlationsSarcoidosis of the cardiac conducting systemClinicopathologic correlations. De subitaneis mortibus. XXV. Sarcoid heart disease.Sarcoidosis of the heartMorphologische Befunde beim kompletten HerzblockCase 42-1965UNUSUAL GIANT CELL LESIONS IN BIOPSY SPECIMENS OF LEFT ATRIAL APPENDAGES IN MITRAL STENOSISAnatomic basis for atrioventricular blockThe pathology of complete atrioventricular blockBILATERAL ADRENAL CALCIFICATION WITH NORMAL ADRENOCORTICAL FUNCTIONSarcoid of the myocardial septum with complete heart block Report of two casesAdams-Stokes syndromeSarcoid Heart DiseaseSarcoidosis Cordis 1 October 1959Volume 51, Issue 4Page: 811-820KeywordsCardiovascular therapyElectrocardiographyHeartHospital medicineIsoproterenolMedical servicesMyocarditisStenosisSyncopeYoung adults ePublished: 1 December 2008 Issue Published: 1 October 1959 PDF downloadLoading ...
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