Document Type

Report

Publication Date

5-28-2025

Comments

This article is the author's final published version in JACC: Case Reports, Volume 30, Issue 12, May 2025, Article number 103373.

The published version is available at https://doi.org/10.1016/j.jaccas.2025.103373.

Copyright © 2025 Published by Elsevier on behalf of the American College of Cardiology Foundation

Abstract

BACKGROUND: Although endomyocardial biopsy (EMB) is the criterion standard for diagnosis of infiltrative cardiac disease, cardiac sarcoidosis (CS) or cardiac amyloid can be diagnosed noninvasively through both clinical suspicion and advanced imaging techniques of cardiac magnetic resonance imaging (CMR) or cardiac positron emission tomography (PET).

CASE SUMMARY: A 79-year-old man with mediastinal sarcoidosis presented with new chest pain and a right bundle branch block, raising concern for CS. CMR and cardiac PET also supported the diagnosis of CS, but EMB ultimately revealed transthyretin amyloid cardiomyopathy. The patient was started on tafamidis and showed improvement at 1-year follow-up.

DISCUSSION: This case shows that cardiac amyloidosis can masquerade as CS when following conventional diagnostic pathways. Without EMB, this patient would have been treated with steroids for CS, which is not a risk-free therapy.

TAKE-HOME MESSAGE: It is possible to misdiagnose CS in the setting of amyloidosis when using advanced noninvasive imaging techniques such as CMR and cardiac PET.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

Language

English

PubMed ID

40447370

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