In a 62-year-old woman with cardiac sarcoidosis, corticosteroid therapy resolved exercise-induced second-degree AV block and improved chronotropic response and exercise tolerance.
Case Report (n=1)
Does corticosteroid therapy improve chronotropic incompetence and AV block in early cardiac sarcoidosis?
Serial exercise echocardiography can quantify chronotropic and hemodynamic recovery during corticosteroid therapy in early cardiac sarcoidosis.
BACKGROUND: Cardiac sarcoidosis (CS) can cause conduction disturbances and heart failure. Chronotropic incompetence due to atrioventricular (AV) conduction abnormalities may represent an early and potentially reversible manifestation of CS. CASE SUMMARY: A 62-year-old woman with suspected CS presented with exertional dyspnea and exercise-induced second-degree AV block. Despite preserved left ventricular systolic function at rest, cardiopulmonary exercise testing combined with exercise echocardiography revealed a severely impaired chronotropic response and inadequate cardiac output augmentation. 18F-fluorodeoxyglucose positron emission tomography showed focal septal myocardial uptake, and skin biopsy confirmed sarcoidosis. After corticosteroid therapy, the AV block resolved with improved heart rate response, cardiac output, and exercise tolerance. DISCUSSION: Chronotropic incompetence due to reversible AV conduction delay may occur as an early manifestation of CS and improve with timely corticosteroid therapy. TAKE-HOME MESSAGE: Serial exercise echocardiography quantifies chronotropic and hemodynamic recovery during corticosteroid therapy and aids early detection of cardiac sarcoidosis.
Katsui et al. (Wed,) conducted a case report in Cardiac sarcoidosis (n=1). Corticosteroid therapy was evaluated on Resolution of AV block and improvement in heart rate response, cardiac output, and exercise tolerance. In a 62-year-old woman with cardiac sarcoidosis, corticosteroid therapy resolved exercise-induced second-degree AV block and improved chronotropic response and exercise tolerance.