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Abstract

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Article in Japanese

Case Report

A case of sarcoidosis exhibiting changes in electrocardiogram findings over time prior to the development of cardiac lesions

Naoya Miyashitaa  Tetsuo Yamaguchia  Takeshi Kawanobea  Chiyoko Kounoa  Yoshihito Yamadaa  Michiaki Hiroeb 

aDepartment of Respiratory Medicine, JR Tokyo General Hospital
bDepartment of Cardiology, National Center for Global Health and Medicine

ABSTRACT

An 80-year-old woman diagnosed with sarcoidosis at 74 years of age had been continuously on oral low-dose corticosteroids for treatment. Four years later, she developed complete right bundle branch block on ECG, and one year later, ECG changes as a first-degree atrioventricular block were observed. However, she remained asymptomatic. After one year, she developed acute onset of cardiac failure. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) revealed strong uptake in the bilateral hilar and mediastinal lymph nodes and in the heart of the anteroseptal and lateral walls and the right ventricle. These were suspected to be cardiac lesions associated with sarcoidosis. Following intensive steroid therapy, the patient exhibited improvement in terms of the atrioventricular block and FDG-PET findings. Physicians in the respiratory medicine field should be careful regarding the development of cardiac lesions among cases with sarcoidosis. In particular, serial changes on ECG findings might be important for suggesting the existence of cardiac involvements even though they have no symptoms or signs.

KEYWORDS

Sarcoidosis  Electrocardiogram  A-V block  Cardiac lesion  18F-fluorodeoxyglucose positron emission tomography 

Received 26 Dec 2014 / Accepted 16 Feb 2015

AJRS, 4(3): 244-248, 2015

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