Author ORCID Identifier
0000-0002-0372-187X
Abstract
There are often remarkably long delays in the diagnosis of cardiac sarcoidosis. We present a case of a 61-year-old man with exertional dyspnea and light-headedness. A resting ECG showed a 1st-degree AV block. A complete heart block was unmasked by an exercise stress test. The coronary angiogram was normal as were the cardiac troponins and Lyme antibody titer. He received a pacemaker on an emergent basis. Cardiac PET scan confirmed sarcoidosis. Computed tomography of the chest was significant for hilar and mediastinal adenopathy. He was treated with methotrexate with good symptom relief. This case demonstrates the importance of prompt clinical suspicion and immediate stress testing to unmask higher degree heart blocks in patients with cardiac sarcoidosis, which would have been missed otherwise. Treatment with a pacemaker, an ICD, and an immunosuppressant is recommended in such patients.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Tirthani E, Pendela V, Kudaravalli P, Balmer-Swain M. A Case of Stress-Related Heart Block in Cardiac Sarcoidosis. Advances in Clinical Medical Research and Healthcare Delivery. 2021; 1(2). doi: 10.53785/2769-2779.1022.
Publisher Note
All articles published in ACMRHD are distributed with a Creative Commons CC BY-NC 4.0 license. Under this license, authors hold the copyright to their work and have the right to share or adapt the article with no restrictions, as long as the author(s) and source are cited, and the use is for noncommercial purposes. This policy went into effect November 1, 2023, and applies retroactively to all articles published in ACMRHD prior to that date, as well.