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- Received September 13, 2010
- Accepted October 1, 2010
- Published online July 19, 2011.
A 63-year-old man with prior history of melanoma presented with new onset dyspnea and atrial fibrillation. The patient was treated medically with spontaneous cardioversion to normal sinus rhythm but remained clinically symptomatic. Transthoracic echocardiography demonstrated normal cardiac structure and function. Chest x-ray demonstrated the presence of multiple pulmonary nodules, which was confirmed on chest computed tomography. A positron emission tomography (PET)/computed tomography scan demonstrated abnormal areas of fluorodeoxyglucose (FDG) uptake in several of the nodules with patchy uptake in the heart (A, arrows). Cardiac magnetic resonance (CMR) demonstrated normal cardiac function but multiple areas of myocardial inflammation (B, arrow) and fibrosis (C, arrows) in both the right and left ventricle in a nonischemic pattern, which matched the areas of patchy uptake noted on PET (D). Lung biopsy confirmed a diagnosis of sarcoidosis. The patient was started on systemic steroids and received an internal cardiac-defibrillator for primary prevention of sudden cardiac death.
- Received September 13, 2010.
- Accepted October 1, 2010.
- American College of Cardiology Foundation