Severe ventricular arrhythmias in a patient with cardiac sarcoidosis: insights from MRI and PET imaging and importance of early corticosteroid therapy.

摘要

A 37-year-old male was referred to our institution for evaluation of exertional angina and non-sustained ventricular tachycardia. Physical examination and laboratory results were normal. The echocardiogram (Panel £) revealed left ventricular (LV) hypertrophy (interventricu-lar septum 16 mm, posterior wall 13.8 mm) with normal ejection fraction. Coronary angiography was normal. Further exploration including cardiac magnetic resonance imaging showed perfusion defects in the basal septal and apical segments (Panel A) as well as a delayed enhancement in the same segments (Panel 8). ~(99m)Tc-tetrofosmin scintigraphy demonstrated basal septal and apical LV hypoperfusion (Panel C) and cardiac ~(18)F-Fluorodeoxyglucose Positron Emission Tomography (~(18)F-FDG-PET) scanning revealed intense glucose metabolism in the same myocardial segments (Panel D). Whole body ~(18)F-FDG scanning showed pathological uptake in the heart, thoracic, and abdominal lymph nodes, as well as in the lungs and the spleen.