ABSTRACT
We herein report a woman diagnosed with cardiac sarcoidosis (CS) based on the presence of epithelioid granulomas in non-cardiac organs and clinical findings including sustained ventricular tachycardia (VT) and cardiac dysfunction. She stopped oral corticosteroid after 4 years of treatment, and an abnormal myocardial uptake of fluorine-18 fluorodeoxyglucose and sustained VT recurred 3.5 years later. There is no consensus concerning whether or not corticosteroid therapy should be discontinued in the treatment of CS. As a relapse of sarcoidosis-related inflammation may be associated with life-threatening arrhythmia, some patients should continue corticosteroid therapy, even at low doses.
Subject(s)
Adrenal Cortex Hormones/administration & dosage , Cardiomyopathies/pathology , Sarcoidosis/pathology , Tachycardia, Ventricular/pathology , Cardiomyopathies/complications , Female , Fluorodeoxyglucose F18/pharmacokinetics , Humans , Middle Aged , Sarcoidosis/complications , Tachycardia, Ventricular/complications , Tachycardia, Ventricular/therapyABSTRACT
We experienced 2 patients who died early after emergency cardiac operation because of malignant diseases. In one case, we operated on a 67-year-old woman for infective endocarditis and performed aortic valve replacement, but she died of terminal pancreatic cancer on the 26 postoperative day. In the other case, a 53-year-old woman underwent emergency operation for cardiac tumor of the left atrium. However, the tumor was diagnosed as cardiac sarcoma during the operation, and it could not be completely resected. The sarcoma recurred after 2 months and she passed away. An emergency cardiac operation without enough preoperative examinations sometimes causes a poor prognosis.
Subject(s)
Cardiac Surgical Procedures , Emergencies , Heart Neoplasms/diagnosis , Pancreatic Neoplasms/diagnosis , Sarcoma/diagnosis , Aged , Aortic Valve/surgery , Coronary Artery Bypass , Female , Heart Atria , Heart Neoplasms/surgery , Humans , Middle AgedABSTRACT
We report a pediatric case of successful cardiac resynchronization therapy (CRT) for acute relapsed deterioration of dilated cardiomyopathy with cardiac dyssynchrony due to a noncompacted left ventricle (LV). A 20-month-old female developed severe congestive heart failure, which was classified as New York Heart Association class IV. She failed to thrive despite intravenous inotropic support. Her LV function and dimension improved markedly after CRT. The beneficial effect of CRT in this patient has remained for more than 3 years.
Subject(s)
Cardiac Resynchronization Therapy/methods , Cardiomyopathy, Dilated/etiology , Isolated Noncompaction of the Ventricular Myocardium/complications , Ventricular Dysfunction, Left/physiopathology , Cardiomyopathy, Dilated/therapy , Echocardiography , Female , Humans , Infant , Isolated Noncompaction of the Ventricular Myocardium/therapy , Treatment Outcome , Ventricular Dysfunction, Left/therapyABSTRACT
We report a surgical case of severe left ventricular dysfunction due to cardiac sarcoidosis. A 45-year-old man who underwent pacemaker implantation for complete atrioventricular block was admitted to the hospital because of dyspnea due to congestive heart failure. Echocardiography revealed a left ventricular ejection fraction of 11%, with severe mitral insufficiency and thinning of the ventricular septum. He was successfully treated by anteroseptal ventricular exclusion, mitral and tricuspid annuloplasty, and bi-ventricular pacing. Postoperative pathologic study revealed noncaseating granulomas. The patient was referred to a cardiologist for further treatment with prednisone.
