BMI, body mass index; DBP, diastolic blood pressure; NS, not significant; SDP, systolic blood pressure; sGFR, single-kidney glomerular filtration rate. Mean AE SD, median (Q1-Q3), and P values were determined by analysis of variance test. a c 2 test, and b Kruskal-Wallis test.
Sarcoidosis is a systemic disorder of uncertain etiology characterized by noncaseating granulomatous inflammation. The disease often involves the heart on autopsy, but the antemortem diagnosis of cardiac sarcoidosis is frequently missed. Cardiac involvement usually includes granulomatous inflammation or fibrosis of the myocardium, conduction system, or pericardium. We now describe a case of epicardial coronary involvement by sarcoidosis, where the diagnosis was made by surgical biopsy of the coronary artery in an African American man presenting with acute coronary syndrome and recurrent symptomatic restenosis following coronary intervention. The case extends the spectrum of common cardiac syndromes that cardiac sarcoidosis can masquerade as and highlights the importance of maintaining a high index of suspicion for early recognition and instituting specific treatment that might improve prognosis. A review of the literature also suggests the need for improvement in diagnostic approaches and prospective clinical trials to establish the best management strategy for this disease.
While ABS mimics AMI, AMI with spontaneous clot lysis may also mimic ABS, and at least in some patients, be mistaken for ABS. ABS is characterized by the absence of MDE and complete myocardial viability on CMR. The diagnosis of ABS can be excluded if CMR demonstrates MDE consistent with myocardial necrosis in a pattern and distribution consistent with AMI.
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