A 62-year-old man without medical history presented with a cardiac tamponade due to a voluminous sterile hemorrhagic exudate. Hypermetabolic mediastinal lymph nodes were found on a PET-CT and pathological analysis revealed non-necrotizing granulomatous adenitis, a finding compatible with sarcoidosis. Steroids were started with rapid clinical improvement and complete resolution of the pericardial effusion.Although pericardial effusions are occasionally seen in cardiac sarcoidosis, symptomatic pericardial involvement with evolution to a tamponade is rare. Our patient is the 7th described case of a sarcoidosis presenting as a tamponade.
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