Cardiac sarcoidosis manifesting with atrioventricular block and intracardiac masses: case report and literature review

European Heart Journal - Case Reports

12 August 2024
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ESC Journals ARRHYTHMIAS AND DEVICE THERAPY IMAGING Cardiac Magnetic Resonance (CMR) Nuclear Imaging Device Therapy Syncope and Bradycardia

Abstract

AbstractBackground

Cardiac sarcoidosis (CS) typically manifests with atrioventricular block (AVB), ventricular arrhythmias, or heart failure. Intracardiac masses due to CS are rare, and there is both a paucity of evidence and guidelines of how manage them.

Case summary

We describe a 45-year-old woman who presented with palpitations and dyspnoea on exertion found to have second-degree AVB. Further work-up noted two right atrial masses that, following excision and pathology, were identified as CS. Within several months of immunosuppressive treatment, imaging and device reports demonstrated mass resolution without arrhythmia recurrence.

Discussion

Intracardiac masses are a rare manifestation of CS. Immunosuppressive therapy remains the mainstay of treatment, with consideration of mass resection for diagnostic purposes.