CTICasesIsolated Cardiac Sarcoidosis with Ventricular Tachycardia
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Imaging findings
A 49-year-old woman experienced dizziness, lightheadedness, and ventricular tachycardia (V-tac) while jogging. Cardiac MRI showed asymmetric thickening within the interventricular septum, with quantitatively elevated T2 signal indicative of edema. Delayed enhancement images revealed patchy delayed enhancement in the septum and extending into the right ventricle. Coronary arteries were clean. Endomyocardial biopsy confirmed non-caseating granulomas, consistent with cardiac sarcoidosis, without evidence of pulmonary sarcoid or mediastinal lymphadenopathy.
Key takeaways
This case highlights isolated cardiac sarcoidosis presenting with life-threatening ventricular arrhythmia (V-tac) and sudden cardiac arrest. Cardiac MRI is crucial for diagnosis, demonstrating features such as asymmetric septal thickening, edema on T2 mapping, and characteristic patchy delayed enhancement. It underscores that cardiac sarcoidosis can occur in isolation and is a known cause of sudden cardiac death.
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