Cardiac sarcoidosis in monozygotic twins: An opportunity for early surveillance and treatment.

Genetic factors play an important role in the development of cardiac sarcoidosis and may determine disease pattern, severity, and prognosis. A 55-year-old African American male presented with new onset of congestive heart failure. This patient was diagnosed with pulmonary sarcoidosis eleven years prior and initially treated with prednisone. He was lost to follow-up until this index admission. He had a monozygotic twin brother who was diagnosed with pulmonary and cardiac sarcoidosis, and passed away from severe biventricular dysfunction. Surveillance, with echocardiography or cardiac MRI, in siblings at high risk of sarcoidosis may allow for early detection and treatment.