Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Right Ventricular Cardiomyopathy Meeting the Arrhythmogenic Right Ventricular Dysplasia Revised Criteria? Don't Forget Sarcoidosis!

  • Vasaturo, Sabina (Department of Radiology, Leiden University Medical Center) ;
  • Ploeg, David E. (Department of Pathology, Leiden University Medical Center) ;
  • Buitrago, Guadalupe (Department of Radiology, Hospital General Universitario Gregorio Maranon) ;
  • Zeppenfeld, Katja (Department of Cardiology, Leiden University Medical Center) ;
  • Veselic-Charvat, Maud (Department of Pathology, Leiden University Medical Center) ;
  • Kroft, Lucia J.M. (Department of Radiology, Leiden University Medical Center)
  • Received : 2014.07.10
  • Accepted : 2015.01.12
  • Published : 2015.06.01
⟨ Previous Next ⟩

Abstract

A 53-year-old woman was referred for ventricular fibrillation with resuscitation. A CT-angiography showed signs of a right ventricular enlargement without obvious cause. A cardiac MRI demonstrated a dilated and hypokinetic right ventricle with extensive late gadolinium enhancement. Arrhythmogenic right ventricular dysplasia (ARVD) was suspected according to the "revised ARVD task force criteria". An endomyocardial biopsy was inconclusive. The patient developed purulent pericarditis after epicardial ablation therapy and died of toxic shock syndrome. The post-mortem pathologic examination demonstrated sarcoidosis involving the heart, lungs, and thyroid gland.

Keywords

References

  1. Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med 2007;357:2153-2165 https://doi.org/10.1056/NEJMra071714
  2. Mantini N, Williams B Jr, Stewart J, Rubinsztain L, Kacharava A. Cardiac sarcoid: a clinician's review on how to approach the patient with cardiac sarcoid. Clin Cardiol 2012;35:410-415 https://doi.org/10.1002/clc.21982
  3. Roberts WC, McAllister HA Jr, Ferrans VJ. Sarcoidosis of the heart. A clinicopathologic study of 35 necropsy patients (group 1) and review of 78 previously described necropsy patients (group 11). Am J Med 1977;63:86-108 https://doi.org/10.1016/0002-9343(77)90121-8
  4. Corrado D, BaBo C, Thiene G, McKenna WJ, Davies MJ, Fontaliran F, et al. Spectrum of clinicopathologic manifestations of arrhythmogenic right ventricular cardiomyopathy/dysplasia: a multicenter study. J Am Coll Cardiol 1997;30:1512-1520 https://doi.org/10.1016/S0735-1097(97)00332-X
  5. Lorenz CH, Walker ES, Morgan VL, Klein B, Graham TP Jr. Normal human right and left ventricular maB, systolic function, and gender differences by cine magnetic resonance imaging. J Cardiovasc Magn Reson 1999;1:7-21 https://doi.org/10.3109/10976649909080829
  6. Marcus FI, McKenna WJ, Sherrill D, BaBo C, Bauce B, Bluemke DA, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the task force criteria. Circulation 2010;121:1533-1541 https://doi.org/10.1161/CIRCULATIONAHA.108.840827
  7. Lagana SM, Parwani AV, Nichols LC. Cardiac sarcoidosis: a pathology-focused review. Arch Pathol Lab Med 2010;134:1039-1046
  8. Yared K, Johri AM, Soni AV, Johnson M, Alkasab T, Cury RC, et al. Cardiac sarcoidosis imitating arrhythmogenic right ventricular dysplasia. Circulation 2008;118:e113-e115 https://doi.org/10.1161/CIRCULATIONAHA.107.755215
  9. Vasaiwala SC, Finn C, Delpriore J, Leya F, Gagermeier J, Akar JG, et al. Prospective study of cardiac sarcoid mimicking arrhythmogenic right ventricular dysplasia. J Cardiovasc Electrophysiol 2009;20:473-476 https://doi.org/10.1111/j.1540-8167.2008.01351.x
  10. Ladyjanskaia GA, BaBo C, Hobbelink MG, Kirkels JH, Lahpor JR, Cramer MJ, et al. Sarcoid myocarditis with ventricular tachycardia mimicking ARVD/C. J Cardiovasc Electrophysiol 2010;21:94-98 https://doi.org/10.1111/j.1540-8167.2009.01479.x
  11. Hunold P, Wieneke H, Bruder O, Krueger U, SchloBer T, Erbel R, et al. Late enhancement: a new feature in MRI of arrhythmogenic right ventricular cardiomyopathy? J Cardiovasc Magn Reson 2005;7:649-655 https://doi.org/10.1081/JCMR-200065608
  12. Santangeli P, Hamilton-Craig C, Dello RuBo A, Pieroni M, Casella M, Pelargonio G, et al. Imaging of scar in patients with ventricular arrhythmias of right ventricular origin:cardiac magnetic resonance versus electroanatomic mapping. J Cardiovasc Electrophysiol 2011;22:1359-1366 https://doi.org/10.1111/j.1540-8167.2011.02127.x
  13. Cain MA, Metzl MD, Patel AR, Addetia K, Spencer KT, SweiB NJ, et al. Cardiac sarcoidosis detected by late gadolinium enhancement and prevalence of atrial arrhythmias. Am J Cardiol 2014;113:1556-1560 https://doi.org/10.1016/j.amjcard.2014.01.434
  14. Ordovas KG, Higgins CB. Delayed contrast enhancement on MR images of myocardium: past, present, future. Radiology 2011;261:358-374 https://doi.org/10.1148/radiol.11091882
  15. Watanabe E, Kimura F, Nakajima T, Hiroe M, Kasai Y, Nagata M, et al. Late gadolinium enhancement in cardiac sarcoidosis: characteristic magnetic resonance findings and relationship with left ventricular function. J Thorac Imaging 2013;28:60-66 https://doi.org/10.1097/RTI.0b013e3182761830

Cited by

  1. How to Evaluate for and Manage Inflammatory and Infiltrative Cardiomyopathies that Require Ventricular Tachycardia Ablation vol.11, pp.12, 2015, https://doi.org/10.1007/s12170-017-0563-4
  2. Isolated Cardiac Sarcoidosis Mimicking Arrhythmogenic Right Ventricular Cardiomyopathy vol.57, pp.6, 2015, https://doi.org/10.2169/internalmedicine.9395-17
  3. Myocardial Involvement in Patients With Histologically Diagnosed Cardiac Sarcoidosis: A Systematic Review and Meta‐Analysis of Gross Pathological Images From Autopsy or Cardiac Transplantation vol.8, pp.10, 2015, https://doi.org/10.1161/jaha.118.011253