Undiagnosed Cardiac Sarcoidosis Causing Refractory Heart Failure After Acute Myocardial Infarction due to Thromboembolism

  • Kai Takashi
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Ono Yoshiyasu
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University Department of Cardiology, Munakata Suikokai General Hospital
  • Matsushima Shouji
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Shinohara Keisuke
    Department of Experimental and Clinical Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Nakashima Ryosuke
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Kawahara Takuro
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Katsuki Masato
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Fujino Takeo
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Hashimoto Toru
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University Department of Advanced Cardiopulmonary Failure, Faculty of Medical Sciences, Kyushu University
  • Higo Taiki
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Tsutsui Hiroyuki
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University

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<p>A 61-year-old woman suffered chest pain and was admitted to a nearby hospital emergency department. She was diagnosed with acute myocardial infarction probably due to thromboembolism in the left anterior descending coronary artery and aspiration thrombectomy was performed. Afterwards, she developed refractory heart failure with severe global left ventricular dysfunction and was transferred to our hospital. An 18F-FDG-PET/CT scan revealed abnormal 18F-FDG uptake in non-infarcted regions of the left ventricle. Non-caseating granulomas were detected by biopsy from a skin eruption. She was diagnosed with cardiac sarcoidosis. In cases of refractory heart failure which cannot be explained only by myocardial infarction, evaluation of other undiagnosed cardiomyopathies is important for optimal management.</p>

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