A Young Male Cardiac Sarcoidosis Case with Complete Atrioventricular Block Which was Improved by Corticosteroid Therapy

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  • Kida Yoko
    Division of Cardiology, Nishi-Kobe Medical Center
  • Tomioka Hiromi
    Division of Respiratory Medicine, Nishi-Kobe Medical Center Division of Respiratory Medicine, Kobe Nishi City Hospital
  • Eizawa Hiroshi
    Division of Cardiology, Nishi-Kobe Medical Center
  • Kato Hiroshi
    Division of Cardiology, Nishi-Kobe Medical Center
  • Hashimoto Kimio
    Division of Pathology, Nishi-Kobe Medical Center
  • Iwasaki Hironobu
    Division of Respiratory Medicine, Nishi-Kobe Medical Center

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Other Title
  • 完全房室ブロックで発症し，ステロイド治療により改善した心臓サルコイドーシスの若年男性例

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Description

Cardiac involvement of sarcoidosis is important because of the high risk of death. Although the diagnosis of myocardial sarcoidosis is often difficult to confirm, early diagnosis and early corticosteroid therapy are important factors to improve the prognosis of cardiac sarcoidosis. We describe herein a case of cardiac sarcoidosis with complete atrioventricular block which was improved by corticosteroid therapy. A 28-year-old Japanese man was referred to our hospital because of an abnormal ECG showing complete atrioventricular block which was detected by a heath check-up. His chest radiographs and computed tomographs revealed consolidation on the right upper lobe. Bronchoscopy was performed and transbronchial lung biopsy showed non-caseating epitheloid cell granulomas. Transthoracic echocardiogram showed the thinning of the basal portion of the ventricular septum and 99mTc-tetorofosmin scintigram showed decreased uptake on ventricular septal, and inferior and free anterior wall. From these observations the diagnosis of cardiac sarcoidosis was made and prednisolone 30mg/day started. Thereafter, ECG abnormalities gradually improved and now his ECG shows normal sinus rhythms at a dose of 10mg a day of prednisolone. With the improvement of atrioventricular conduction disturbance, abnormalities of cardiac scintigraphy and echocardiogram also improved.

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