CTICasesCardiac Sarcoidosis
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Imaging findings
The patient, a former athlete with fatigue and conduction abnormalities, underwent cardiac MRI and PET/CT. Cardiac MRI demonstrated delayed enhancement in the septum and RV wall. FDG-PET showed focal uptake in these areas of myocardial enhancement and in hypermetabolic mediastinal lymph nodes, despite the nodes appearing non-enlarged on CT. Coregistration of the images confirmed the correlation between structural damage and metabolic activity, supporting the diagnosis of cardiac sarcoidosis.
Key takeaways
Cardiac sarcoidosis may present with conduction abnormalities and fatigue, often without overt pulmonary disease. Multimodality imaging with cardiac MRI and FDG-PET is powerful for diagnosis, especially when PET can identify metabolically active but structurally normal-sized lymph nodes.
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