Sarcoidosis with predominant cardiac involvement

Abstract We present a case of predominantly myocardial sarcoidosis in a 38 year-old man. A second degree atrioventricular block was the clinical presentation, followed 2 years later by sudden cardiac arrest. Autopsy revealed large areas of myocardial scarring in the left ventricular wall unassociated with atherosclerotic coronary lesions; microscopy of these areas disclosed epithelioid granuloma with giant cells embedded in a fibrohyaline tissue. The insidious cardiac involvement in sarcoidosis often hinders an exact diagnosis in life, and prognosis without therapy is severe. Histopathologic diagnosis is made only by exclusion of other systemic granulomatous diseases.