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Complete diagnostic work-up and prognosis prediction for cardiac sarcoidosis with atrioventricular block: Importance of cardiac magnetic resonance image (MRI) and positron emission tomography (PET)
Ki Hong Lee and Jeong Gwan ChoA 56-year old woman complained of chest discomfort and dyspnea on exertion for one month. She had been diagnosed as mediastinal lymph node sarcoidosis through endobronchial ultrasonography guided transbronchial lymph node aspiration. Electrocardiogram at presentation demonstrated sequential first and second degree 2:1 atrioventricular block. Further imaging study with gadolinium enhanced cardiac magnetic resonance image and 18F-fluoro-2-deoxyglucose positron emission tomography confirmed the diagnosis of sarcoidosis involving heart. Intravenous steroid therapy without pacemaker implantation improved conduction abnormality to normal sinus rhythm. Follow-up 18F-FDG-PET demonstrated full improvement of cardiac and extracardiac lesion with maintenance oral steroid therapy for 5-month.