An Autopsy Case of Cardiac Sarcoidosis Presenting with Hoarseness

Abstract

A 54-year-old Japanese woman, who had been diagnosed as sarcoidosis, was referred to our hospital in July 1992. She noticed hoarseness in March 1989. Laryngeal biopsy failed to clarify the cause of hoarseness. Diagnosis of sarcoidosis was made in September by mediastinal lymph node biopsy. She developed chest pain in August 1990 and cardiovascular examinations were performed. However, there were no abnormalities in electrocardiography and echocardiography. In March 1992, corticosteroid therapy was started because of the enlargement of cardiac silhoutte. She developed frequent premature ventricular contractions and chronic heart failure and was hospitalized in July 1992. Severe left ventricular hypokinesia, marked decrease in LVEF and defect in ²⁰¹Thallium myocardial scintigraphy were shown. She was discharged in December after the iniation of digitalis, diuretic drugs, and antiarrhythmic drugs. She was hospitalized in July 1999 for severe heart failure and died in August. The autopsy revealed noncaseating epithelioid cell granulomas in mediastinal lymph nodes. In the heart muscle, fibrosis and granulomatous changes were observed.