Key result
Corticosteroids plus CRT-D successfully manage suspected isolated cardiac sarcoidosis presenting with high-grade AV block.
Why the study?
Isolated cardiac sarcoidosis presentations causing advanced atrioventricular block, ventricular dysfunction, and sudden cardiac death are diagnostically challenging when histologic confirmation and fluorodeoxyglucose positron emission tomography are unavailable.
Case Report (n=1)
This case highlights the importance of considering isolated cardiac sarcoidosis alongside mimics like giant cell myocarditis in young patients presenting with malignant conduction disease, recurrent cardiac arrest, and inflammatory cardiomyopathy.
Raises suspicion for isolated cardiac sarcoidosis in young patients with unexplained high-grade AV block; leaves open validation of noninvasive diagnostic criteria.
BACKGROUND: Cardiac sarcoidosis may cause advanced atrioventricular block, ventricular dysfunction, and sudden cardiac death. Isolated cardiac presentations are diagnostically challenging when histologic confirmation and fluorodeoxyglucose positron emission tomography are unavailable. CASE SUMMARY: An 18-year-old woman with recurrent syncope developed high-grade atrioventricular block and recurrent brady-asystolic cardiac arrest requiring temporary transvenous pacing. Echocardiography showed severe left ventricular dysfunction. Cardiac magnetic resonance demonstrated regional septal thickening, basal to midseptal midmyocardial late gadolinium enhancement and a left ventricular ejection fraction of 38.9%. No extracardiac sarcoid pattern or biopsy target was identified. Giant cell myocarditis and inherited cardiomyopathy remained important alternative diagnoses. She received corticosteroid therapy and subsequently underwent cardiac resynchronization therapy-defibrillator implantation. CONCLUSION: Cardiac sarcoidosis should remain a diagnostic consideration in young patients with malignant conduction disease and inflammatory cardiomyopathy, while important mimics must be actively considered.
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Talib et al. (2026) conducted a case report in Suspected isolated cardiac sarcoidosis with high-grade atrioventricular block and recurrent cardiac arrest (n=1). Corticosteroid therapy and cardiac resynchronization therapy-defibrillator implantation was evaluated. Corticosteroid therapy and CRT-D implantation were used to treat an 18-year-old woman with suspected isolated cardiac sarcoidosis, high-grade AV block, and LVEF of 38.9%.
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