AI Article Synopsis

  • - Diagnosing cardiac sarcoidosis (CS) is difficult, often leading to heart transplantation (HT) as the last option, especially when immunosuppressive therapies fail in advanced cases.
  • - The case study presents four patients, each with different symptoms and backgrounds, who ultimately required HT for their CS, revealing the condition's complexity and urgency.
  • - There are significant mid- and long-term challenges following HT for CS, notably the need for careful management of immunosuppression to prevent rejection and recurrence of sarcoidosis.

Article Abstract

Background: Diagnosing cardiac sarcoidosis (CS) is challenging. Immunosuppressive therapies are less effective in end-stage disease, and often heart transplant (HT) is the only available option. We present a series of advanced CS cases, requiring HT, along with a review of the literature evidence in this field.

Case Summary: Case 1: a 49-year-old man initially suspected of having arrhythmogenic cardiomyopathy (ACM) presented with heart failure (HF) and recurrent ventricular arrhythmias. The rapid clinical deterioration raised suspicion of an inflammatory aetiology, which was confirmed through endomyocardial biopsy, diagnosing CS. Despite immunosuppressive therapy, HT was required. Case 2: a 36-year-old woman presented with high-grade atrioventricular block and dilated cardiomyopathy (DCM), initially diagnosed as idiopathic. Due to worsening HF, she required HT. The pathological examination of the explanted heart revealed CS. Chronic subclinical antibody-mediated rejection was observed after HT. Case 3: a 44-year-old man presented with syncope and imaging suggesting ACM. He was referred for HT due to high ventricular arrhythmic burden. Cardiac sarcoidosis diagnosis was suspected due to pulmonary involvement and then confirmed on post-explant pathological exam. Post-HT pulmonary and cutaneous sarcoidosis reactivation were observed. Case 4: a 43-year-old man was diagnosed with pulmonary sarcoidosis after lung biopsy. Progression towards DCM was observed despite immunosuppressive therapy. Post-HT was characterized by multiple episodes of graft rejection.

Discussion: This case series provides insights into mid- and long-term outcomes after HT for CS, highlighting the need for careful management of immunosuppression in these patients, balancing the adverse effects of chronic immunosuppression with the prevention of rejection and sarcoidosis recurrence.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647515PMC
http://dx.doi.org/10.1093/ehjcr/ytae635DOI Listing

Publication Analysis

Top Keywords

cardiac sarcoidosis
12
heart failure
8
heart transplant
8
case series
8
despite immunosuppressive
8
immunosuppressive therapy
8
observed case
8
sarcoidosis
6
case
6
end-stage heart
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!