CTICasesCardiac Sarcoidosis
Imaging findings
Cardiac MRI with delayed gadolinium enhancement demonstrates mid-myocardial enhancement in the inferior wall and anterior septum of the left ventricle in a 62-year-old woman presenting with complete heart block. Chest CT confirms peribronchovascular stellate nodules diagnostic of pulmonary sarcoidosis. FDG PET/CT shows FDG-avid foci in the lung nodules and myocardium corresponding to the areas of gadolinium enhancement.
Key takeaways
Cardiac sarcoidosis classically presents with conduction abnormalities, particularly high-degree AV block, which may be the presenting symptom before any pulmonary manifestations. Multimodality imaging with cardiac MRI (delayed enhancement) and FDG PET/CT is key for characterizing cardiac involvement. Chest CT revealing peribronchovascular nodules confirms the underlying systemic diagnosis.
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