Case Session 05: Systemic and Inflammatory Disease (2018)-Cardiac sarcoidosis with features mimicking hypertrophic obstructive cardiomyopathy

Cardiac sarcoidosis with features mimicking hypertrophic obstructive cardiomyopathy

Video Transcription

Video Summary

A 51-year-old man with known pulmonary sarcoidosis had recurrent syncope, bradycardia, and Mobitz I AV block. Echocardiograms were unrevealing, but cardiac MRI and FDG PET-CT showed basal anteroseptal thickening, LVOT flow acceleration, and mild systolic anterior motion, mimicking hypertrophic obstructive cardiomyopathy. However, abnormal T2 signal, elevated native T1, patchy multifocal late gadolinium enhancement involving the papillary muscle and right ventricular wall, plus mediastinal/hilar lymphadenopathy and myocardial FDG uptake, supported active cardiac sarcoidosis. The case highlights imaging features that help distinguish sarcoidosis from HOCM.

Keywords

cardiac sarcoidosis

hypertrophic obstructive cardiomyopathy

cardiac MRI

FDG PET-CT

late gadolinium enhancement