Two cases of cardiac sarcoidosis in pregnant women with supraventricular arrhythmia: case report

Abstract

We present two cases of cardiac sarcoidosis whose first presentation was in pregnancy. All findings confirmed the diagnosis of sarcoidosis with cardiac involvement in both patients. The first patient, a 37-year-old, presented with dizziness and atrial fibrillation at 16 weeks' gestation. Echocardiography revealed thickened interventricular septum with a speckled pattern. Cardiac MRI after delivery showed myocardial oedema/inflammation corresponding with the same regions with early enhancement and epicardial delayed enhancement in the basal to mid-inferoseptal and basal anterior left ventricular myocardial segments. Transbronchial biopsy revealed histology of scanty fragments of inflamed bronchial mucosa. The second patient, a 31-year-old, was 17 weeks pregnant when she presented with daily palpitations and shortness of breath. She had prolonged episodes of supraventricular tachycardia. Echocardiography revealed a speckled septal and right ventricular wall pattern. Cardiac MRI after delivery showed basal and mid-ventricular mesocardial and epicardial enhancement, most compatible with sarcoidosis.

Utility of cardiovascular magnetic resonance in pregnancy

“…Small observational studies have evaluated the role of CMR in the assessment of aortic disease (28,29) and congenital heart disease in pregnancy. (30,31) Likewise, small studies have reported on the role of CMR in PPCM and DCM (32)(33)(34)(35)(36) (Figure 2) and in myocarditis and infiltrating cardiomyopathy (37) during pregnancy and the puerperium. These studies have reported on a common finding of a poor prognosis in these myocardial disorders when focal myocardial fibrosis indicated by LGE is present.…”