Cardiac Sarcoidosis: F18FDG-PET/CT as the Most Helpful Tool in the Decision Making of Medical Management, and Assessment of Response to Treatment

Abstract

We describe the case of a 32-year-old healthy man who presented to the Emergency Department (ED) with vomiting, dizziness, and diaphoresis in addition to transient episodes of loss of consciousness on the day of admission. The patient's past medical history was unremarkable. Once in the ED triage vitals showed a heart rate of 254 beats per minute and an initial Electrocardiogram (EKG) showing stable monomorphic ventricular tachycardia. After conversion to sinus rhythm the patient was admitted where and after a long array of tests, the patient was diagnosed with cardiac sarcoidosis. Implantable Cardioverter-Defibrillators (ICD) was implanted and he was started on corticosteroids. The medical management of the patient's treatment with corticosteroids was very challenging. Fludeoxyglucose positron emission tomography/ computed tomography (FDG-PET/CT) was the most helpful tool and the test of choice for the follow up in his medical management.