A case of complete atrioventricular block: The use of magnetic resonance imaging conditional pacemakers for diagnosing cardiac sarcoidosis

A 50-year-old man presented to the emergency department with repeated episodes of faintness and exertional dyspnea, and was found to have an atrioventricular (AV) block. Chest radiography and transthoracic echocardiography results were normal, without any evidence of heart failure, wall motion abnor...

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Main Authors: Yosuke Miwa, MD, Kyoko Soejima, Toshiaki Sato, Akiko Maeda, Akiko Ueda, Mutsumi Miyakoshi, Kyoko Hoshida, Satoshi Higuchi, Noriko Matsushita, Mika Nagaoka, Yuichi Momose, Mitsuhiro Kanaya, Hideaki Yoshino
Format: Article
Language:English
Published: Wiley 2014-04-01
Series:Journal of Arrhythmia
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1880427614000271
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author Yosuke Miwa, MD
Kyoko Soejima
Toshiaki Sato
Akiko Maeda
Akiko Ueda
Mutsumi Miyakoshi
Kyoko Hoshida
Satoshi Higuchi
Noriko Matsushita
Mika Nagaoka
Yuichi Momose
Mitsuhiro Kanaya
Hideaki Yoshino
author_facet Yosuke Miwa, MD
Kyoko Soejima
Toshiaki Sato
Akiko Maeda
Akiko Ueda
Mutsumi Miyakoshi
Kyoko Hoshida
Satoshi Higuchi
Noriko Matsushita
Mika Nagaoka
Yuichi Momose
Mitsuhiro Kanaya
Hideaki Yoshino
author_sort Yosuke Miwa, MD
collection DOAJ
description A 50-year-old man presented to the emergency department with repeated episodes of faintness and exertional dyspnea, and was found to have an atrioventricular (AV) block. Chest radiography and transthoracic echocardiography results were normal, without any evidence of heart failure, wall motion abnormalities, interventricular septum thinning, or bilateral hilar lymphadenopathy. A temporary pacemaker was implanted, followed by a permanent pacemaker. Chest computed tomography with contrast enhancement did not show abnormalities, including patent coronary arteries, lymph node adenopathy, and pulmonary abnormalities. Thus, an MRI conditional dual chamber pacemaker and leads were implanted. Six weeks following the implant, a cardiac MRI was performed to test for cardiac sarcoidosis. Although cine imaging showed normal left and right ventricular function, late gadolinium enhancement demonstrated multiple enhanced uptakes. Based on the results of the cardiac MRI, PET, and gallium scintigraphy, the most likely diagnosis was cardiac sarcoidosis. Although no abnormal findings were found on physical examination, blood work, chest radiography, and transthoracic echocardiogram, multiple regions of delayed enhancement were observed in the cardiac MRI. Thus, MRI conditional pacemakers are a useful tool for diagnosing cardiac sarcoidosis and early therapeutic intervention.
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spelling doaj.art-8dec07e33c554a3bbd74b936b6ca7e902022-12-22T03:48:54ZengWileyJournal of Arrhythmia1880-42762014-04-0130211111410.1016/j.joa.2014.01.004A case of complete atrioventricular block: The use of magnetic resonance imaging conditional pacemakers for diagnosing cardiac sarcoidosisYosuke Miwa, MDKyoko SoejimaToshiaki SatoAkiko MaedaAkiko UedaMutsumi MiyakoshiKyoko HoshidaSatoshi HiguchiNoriko MatsushitaMika NagaokaYuichi MomoseMitsuhiro KanayaHideaki YoshinoA 50-year-old man presented to the emergency department with repeated episodes of faintness and exertional dyspnea, and was found to have an atrioventricular (AV) block. Chest radiography and transthoracic echocardiography results were normal, without any evidence of heart failure, wall motion abnormalities, interventricular septum thinning, or bilateral hilar lymphadenopathy. A temporary pacemaker was implanted, followed by a permanent pacemaker. Chest computed tomography with contrast enhancement did not show abnormalities, including patent coronary arteries, lymph node adenopathy, and pulmonary abnormalities. Thus, an MRI conditional dual chamber pacemaker and leads were implanted. Six weeks following the implant, a cardiac MRI was performed to test for cardiac sarcoidosis. Although cine imaging showed normal left and right ventricular function, late gadolinium enhancement demonstrated multiple enhanced uptakes. Based on the results of the cardiac MRI, PET, and gallium scintigraphy, the most likely diagnosis was cardiac sarcoidosis. Although no abnormal findings were found on physical examination, blood work, chest radiography, and transthoracic echocardiogram, multiple regions of delayed enhancement were observed in the cardiac MRI. Thus, MRI conditional pacemakers are a useful tool for diagnosing cardiac sarcoidosis and early therapeutic intervention.http://www.sciencedirect.com/science/article/pii/S1880427614000271MRI conditional pacemakerCardiac sarcoidosis
spellingShingle Yosuke Miwa, MD
Kyoko Soejima
Toshiaki Sato
Akiko Maeda
Akiko Ueda
Mutsumi Miyakoshi
Kyoko Hoshida
Satoshi Higuchi
Noriko Matsushita
Mika Nagaoka
Yuichi Momose
Mitsuhiro Kanaya
Hideaki Yoshino
A case of complete atrioventricular block: The use of magnetic resonance imaging conditional pacemakers for diagnosing cardiac sarcoidosis
Journal of Arrhythmia
MRI conditional pacemaker
Cardiac sarcoidosis
title A case of complete atrioventricular block: The use of magnetic resonance imaging conditional pacemakers for diagnosing cardiac sarcoidosis
title_full A case of complete atrioventricular block: The use of magnetic resonance imaging conditional pacemakers for diagnosing cardiac sarcoidosis
title_fullStr A case of complete atrioventricular block: The use of magnetic resonance imaging conditional pacemakers for diagnosing cardiac sarcoidosis
title_full_unstemmed A case of complete atrioventricular block: The use of magnetic resonance imaging conditional pacemakers for diagnosing cardiac sarcoidosis
title_short A case of complete atrioventricular block: The use of magnetic resonance imaging conditional pacemakers for diagnosing cardiac sarcoidosis
title_sort case of complete atrioventricular block the use of magnetic resonance imaging conditional pacemakers for diagnosing cardiac sarcoidosis
topic MRI conditional pacemaker
Cardiac sarcoidosis
url http://www.sciencedirect.com/science/article/pii/S1880427614000271
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