Cardiac sarcoidosis mimicking arrhythmogenic right ventricular dysplasia in a patient presenting with monomorphic ventricular tachycardia

Biggs, Ross; Patel, Brijesh; Martinez, Matthew W.; McCambridge, Matthew; Kim, Susan; Marcus, Norman

doi:10.1016/j.hrcr.2017.06.008

Cited by 7 publications

(6 citation statements)

References 14 publications

(18 reference statements)

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“…Additionally, systemic autoimmune diseases may involve the heart and manifest as myocarditis [54,55]. In that regard, it is estimated that cardiac involvement is present in 2% to 5% of patients with systemic sarcoidosis [56][57][58][59]. A study in Finland showed that between 1988 and 2012, the number of cases of cardiac sarcoidosis increased significantly, with the prevalence of cardiac sarcoidosis being 2.2 per 100,000 people in 2012 [60].…”

Section: Autoimmunitymentioning

confidence: 99%

Epidemiological Impact of Myocarditis

Golpour

Patriki

Hanson

et al. 2021

JCM

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Myocarditis is an inflammatory disease of the heart muscle with a wide range of potential etiological factors and consequently varying clinical patterns across the world. In this review, we address the epidemiology of myocarditis. Myocarditis was considered a rare disease until intensified research efforts in recent decades revealed its true epidemiological importance. While it remains a challenge to determine the true prevalence of myocarditis, studies are underway to obtain better approximations of the proportions of this disease. Nowadays, the prevalence of myocarditis has been reported from 10.2 to 105.6 per 100,000 worldwide, and its annual occurrence is estimated at about 1.8 million cases. This wide range of reported cases reflects the uncertainty surrounding the true prevalence and a potential underdiagnosis of this disease. Since myocarditis continues to be a significant public health issue, particularly in young adults in whom myocarditis is among the most common causes of sudden cardiac death, improved diagnostic and therapeutic procedures are necessary. This manuscript aims to summarize the current knowledge on the epidemiology of myocarditis, new diagnostic approaches and the current epidemiological impact of the COVID-19 pandemic.

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Section: Autoimmunitymentioning

confidence: 99%

Epidemiological Impact of Myocarditis

Golpour

Patriki

Hanson

et al. 2021

JCM

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“…In young people particularly, the clinical presentation may mimic that of AC, previously known as arrhythmogenic right ventricular dysplasia. Sarcoidosis isolated to the RV has been described in case reports, 3 , 4 but examples of lymphocytic myocarditis causing the same are exceedingly rare with only two published cases identified in the literature. Crudele et al 1 describe a case of acute RV myocarditis, which presented with a flu-like illness, followed by sudden death at 3 weeks, the diagnosis being confirmed on autopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Viral infections associated with the condition include parvovirus B19, adenovirus, and enterovirus. 3 The incidence of myocarditis is estimated to be 22 per 100 000 individuals, with lymphocytic myocarditis accounting for approximately half of these, 4 , 5 although the true incidence is unknown as endomyocardial biopsy, the gold standard for diagnosis is not a routinely performed procedure. We present a histopathologically confirmed case of lymphocytic myocarditis that presented with chronic right ventricular dysfunction, complicated by arrhythmia.…”

Section: Introductionmentioning

confidence: 99%

A case report of isolated right ventricular lymphocytic myocarditis

Indraratna

Sivasubramaniam

Davidson

et al. 2020

European Heart Journal - Case Reports

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Background Lymphocytic myocarditis is an uncommon condition with a variety of clinical presentations. Isolated involvement of the right ventricle (RV) is very rare. We present a case of a young woman who developed right ventricular dysfunction and arrhythmias as a consequence of this condition, which appeared to be chronic at diagnosis. Case summary A 26-year-old lady was admitted to hospital following routine echocardiography, requested for screening of pulmonary hypertension in the context of known hypersensitivity pneumonitis. This echocardiogram demonstrated severe right ventricular dilatation and impairment. She was also experiencing atrial fibrillation and non-sustained, symptomatic episodes of ventricular tachycardia. Endomyocardial biopsy revealed lymphocytic myocarditis. She was managed with azathioprine and prednisone, as well as sotalol and apixaban for her atrial fibrillation, and has had no complications in the 12 months since discharge. Discussion Lymphocytic myocarditis isolated to the RV has only been reported in two previous cases, both of which were acute, dramatic presentations. This is the first report of a chronic example of this disease process. Due to her intercurrent immunosuppression, this patient may have been pre-disposed to the condition either by re-activation of a latent viral infection or partial treatment of a true autoimmune lymphocytic myocarditis.

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“…It is well known that differentiating cardiac sarcoidosis from ARVC can be challenging, and there have been several case reports of sarcoid initially diagnosed as ARVC when RV enlargement was the only structural abnormality identified. 4 , 5 , 6 , 7 , 8 , 9 The suspicion of sarcoidosis is increased by the presence of lymphadenopathy, parenchymal pulmonary nodules, and conduction disturbances, but these are often absent, and the diagnosis may not be established until examination of the heart at necropsy or after cardiac transplantation. 7 Our patient had undergone 6 EPS over 15 years, with catheter ablation targeting symptomatic PVCs.…”

Section: Discussionmentioning

confidence: 99%