興味ある心電図変化を示したサルコイドーシスの1例

Abstract

The patient was a 58-year-old woman with thromboembolism of the left lower leg. A thromboectomy was performed. Microscopic examination of the biopsy specimen obtained from an inguinal lymph node showed sarcoid lesions. An electrocardiogram showed CRBBB and ventricular tachycardia. The QRS comlex was prolonged from 0.14 seconds to 0.18 seconds over a 35 month period. The coronary arteries were intact, but left ventricular function was severely compromised. ²⁰¹Tl scintigraphy showed multiple perfusion defects, and a myocardial biopsy revealed focal myocardial necrosis and fibrosis. Cardiac sarcoidosis was suspected, and corticosteroids were administered. In our patient, the worsening of electrocardiographic findings reflected the progression of sarcoid lesions. The diagnosis of cardiac sarcoidosis may not be easy during life, but careful follow-up of the electrocardiogram can lead to detection of cardiac sarcoidosis in suspected cases.