Severe cardiogenic shock and cardiac arrest due to fulminant cardiac sarcoidosis: a case report
Abstract Background Cardiac sarcoidosis is found to occur in approximately 5% of patients with sarcoidosis. Its presentation can typically range from complete heart block to ventricular arrhythmias. This condition can rarely present with severe heart failure and cardiogenic shock requiring aggressiv...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-023-03238-3 |
| _version_ | 1827952887844569088 |
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| author | Teja Chakrala Roshni O. Prakash Anshul Jain R. Ashton Vautier Sahil Prasada Mohammed Al-Ani Mustafa M. Ahmed |
| author_facet | Teja Chakrala Roshni O. Prakash Anshul Jain R. Ashton Vautier Sahil Prasada Mohammed Al-Ani Mustafa M. Ahmed |
| author_sort | Teja Chakrala |
| collection | DOAJ |
| description | Abstract Background Cardiac sarcoidosis is found to occur in approximately 5% of patients with sarcoidosis. Its presentation can typically range from complete heart block to ventricular arrhythmias. This condition can rarely present with severe heart failure and cardiogenic shock requiring aggressive and timely management strategies. Advanced imaging techniques are usually required to assist with its diagnosis. Case presentation A 70-year-old woman with a history of pulmonary sarcoidosis presented with non-ST elevation myocardial infarction, congestive hepatopathy, and acute renal failure. Left heart catheterization showed evidence of non-obstructive coronary artery disease, and right heart catheterization revealed severely elevated filling pressures and depressed cardiac index. She underwent aggressive diuresis and placement of an intra-aortic balloon pump in addition to initiation of inotropic and vasopressor support. While in the cardiac intensive care unit, she experienced frequent episodes of ventricular tachycardia and went into cardiac arrest requiring cardiopulmonary resuscitation. High clinical suspicion for cardiac sarcoidosis was confirmed by cardiac magnetic resonance imaging findings. After starting immunosuppressive therapy for cardiac sarcoidosis, she demonstrated clinical improvement. Conclusion Patients with cardiac sarcoidosis may remain asymptomatic or present with conduction abnormalities and arrhythmias. They rarely present with severe biventricular heart failure and cardiogenic shock, and in such cases, they require timely initiation of pharmacologic and device therapies, along with implementation of mechanical circulatory support. |
| first_indexed | 2024-04-09T14:05:44Z |
| format | Article |
| id | doaj.art-aa125d25a8a240138badc204218909a2 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-09T14:05:44Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-aa125d25a8a240138badc204218909a22023-05-07T11:04:56ZengBMCBMC Cardiovascular Disorders1471-22612023-05-012311810.1186/s12872-023-03238-3Severe cardiogenic shock and cardiac arrest due to fulminant cardiac sarcoidosis: a case reportTeja Chakrala0Roshni O. Prakash1Anshul Jain2R. Ashton Vautier3Sahil Prasada4Mohammed Al-Ani5Mustafa M. Ahmed6Department of Medicine, University of FloridaDepartment of Medicine, University of FloridaDepartment of Medicine, University of FloridaDivision of Cardiovascular Medicine, University of FloridaDivision of Cardiovascular Medicine, University of FloridaDivision of Cardiovascular Medicine, University of FloridaDivision of Cardiovascular Medicine, University of FloridaAbstract Background Cardiac sarcoidosis is found to occur in approximately 5% of patients with sarcoidosis. Its presentation can typically range from complete heart block to ventricular arrhythmias. This condition can rarely present with severe heart failure and cardiogenic shock requiring aggressive and timely management strategies. Advanced imaging techniques are usually required to assist with its diagnosis. Case presentation A 70-year-old woman with a history of pulmonary sarcoidosis presented with non-ST elevation myocardial infarction, congestive hepatopathy, and acute renal failure. Left heart catheterization showed evidence of non-obstructive coronary artery disease, and right heart catheterization revealed severely elevated filling pressures and depressed cardiac index. She underwent aggressive diuresis and placement of an intra-aortic balloon pump in addition to initiation of inotropic and vasopressor support. While in the cardiac intensive care unit, she experienced frequent episodes of ventricular tachycardia and went into cardiac arrest requiring cardiopulmonary resuscitation. High clinical suspicion for cardiac sarcoidosis was confirmed by cardiac magnetic resonance imaging findings. After starting immunosuppressive therapy for cardiac sarcoidosis, she demonstrated clinical improvement. Conclusion Patients with cardiac sarcoidosis may remain asymptomatic or present with conduction abnormalities and arrhythmias. They rarely present with severe biventricular heart failure and cardiogenic shock, and in such cases, they require timely initiation of pharmacologic and device therapies, along with implementation of mechanical circulatory support.https://doi.org/10.1186/s12872-023-03238-3SarcoidosisHeart failureCardiogenic shockCardiac arrestCase report |
| spellingShingle | Teja Chakrala Roshni O. Prakash Anshul Jain R. Ashton Vautier Sahil Prasada Mohammed Al-Ani Mustafa M. Ahmed Severe cardiogenic shock and cardiac arrest due to fulminant cardiac sarcoidosis: a case report BMC Cardiovascular Disorders Sarcoidosis Heart failure Cardiogenic shock Cardiac arrest Case report |
| title | Severe cardiogenic shock and cardiac arrest due to fulminant cardiac sarcoidosis: a case report |
| title_full | Severe cardiogenic shock and cardiac arrest due to fulminant cardiac sarcoidosis: a case report |
| title_fullStr | Severe cardiogenic shock and cardiac arrest due to fulminant cardiac sarcoidosis: a case report |
| title_full_unstemmed | Severe cardiogenic shock and cardiac arrest due to fulminant cardiac sarcoidosis: a case report |
| title_short | Severe cardiogenic shock and cardiac arrest due to fulminant cardiac sarcoidosis: a case report |
| title_sort | severe cardiogenic shock and cardiac arrest due to fulminant cardiac sarcoidosis a case report |
| topic | Sarcoidosis Heart failure Cardiogenic shock Cardiac arrest Case report |
| url | https://doi.org/10.1186/s12872-023-03238-3 |
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