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Detecting cardiac involvement in sarcoidosis: a call for prospective studies of newer imaging techniques

Depts of ¹ Pulmonary, Allergy and Critical Care Medicine, ² Molecular and Functional Imaging, ³ Cardiovascular Medicine, ⁴ Diagnostic Radiology, and ⁵ Pathobiology, The Cleveland Clinic, Cleveland, OH, USA.

CORRESPONDENCE: D. A. Culver, Dept of Pulmonary, Allergy and Critical Care Medicine, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Fax: 1 2164458160. E-mail: culverd{at}ccf.org

Keywords: Cardiac arrhythmias, granulomatosis, imaging, magnetic resonance imaging, positron emission tomography, sarcoidosis

Received: June 12, 2006
Accepted October 9, 2006

Diagnosis of cardiac involvement in sarcoidosis is challenging and usually relies on a combination of clinical findings and imaging abnormalities.

The case of a 53-yr-old female is described who presented with ventricular tachycardia and suspected angiosarcoma involving the right atrium and superior vena cava.

A combination of magnetic resonance imaging and ¹⁸F-2-fluoro-2-deoxyglucose-positron emission tomography were essential to the diagnosis of cardiac sarcoidosis.

Reversibility of the disease was predicted more clearly by ¹⁸F-2-fluoro-2-deoxyglucose-positron emission tomography than by magnetic resonance imaging, and clinical activity was predicted by persistent hypermetabolism on serial ¹⁸F-2-fluoro-2-deoxyglucose-positron emission tomography.