Cardiovascular Imaging

Cardiomyopathy, sarcoid

dilated or restrictive cardiomyopathy caused by myocardial infiltration by sarcoid granulomas. The most frequently involved sites are the free wall and septal walls of the left ventricle. The cardiac manifestations include sudden death, conduction disturbances and congestive heart failure. Congestive heart failure may be the result of either restrictive cardiomyopathy or dilated cardiomyopathy. Sarcoid is a rare cause of ventricular aneurysm. Echocardiography is nonspecific demonstrating ventricular enlargement and contraction abnormalities in some patients. Perfusion nuclear imaging may display perfusion defects at the sites of myocardial granulomas. Gallium or pyrophosphate nuclear imaging may disclose increased uptake by the myocardial granulomas. Spin echo MRI with T2-weighting or T1-weighting after gadolinium contrast media may show myocardial regions with high intensity representing granulomas.

CBH