Author/Editor		Thangam, Manoj; Nathan, Sriram; Kar, Biswajit; Petrovic, Marija; Loyalka, Pranav; Buja, L. Maximilian; Gregorič, Igor
Title		Primary cardiac sarcoidosis with syncope and refractory atrial arrhythmia
Type		članek
Vol. and No.		Letnik 43, št. 3
Publication year		2016
Volume		str. 236-240
ISSN		0730-2347 - Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital
Language		eng
Abstract		We discuss the case of a 38-year-old black man who presented at our hospital with his first episode of syncope, recently developed atrial arrhythmias refractory to pharmacologic therapy, and a left atrial thrombus. He was diagnosed with primary cardiac sarcoidosis characterized by predominant involvement of the epicardium that caused atrial fibrillation and atrial flutter. Histologic analysis of his epicardial lesions yielded a diagnosis of sarcoidosis. This patient's atrial arrhythmia was successfully treated with a hybrid operation that involved resection of his atrial appendage, an Epicor maze procedure, and radiofrequency ablation during a catheter-based electrophysiologic study. The cardiac sarcoidosis was successfully managed with corticosteroid therapy. Our case report shows that sarcoidosis can initially manifest itself as syncope with new-onset atrial arrhythmia. Sarcoidosis is important in the differential diagnosis because of its progressive nature and its potential for treatment with pharmacologic, surgical, and catheter-based interventions.
Keywords		atrial fibrillation fibrosis sarcoidosis atrijska fibrilacija fibroza sarkoidoza