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Cardiac Sarcoidosis Presented With Hiccups: A Case Report and Literature Review

Sarcoidosis is a multisystem disorder of unknown etiology commonly associated with hilar lymphadenopathy and granulomas. Cardiac involvement is less common; however, sarcoidosis is a known cause of restrictive cardiomyopathy. It typically presents as new-onset arrhythmias or heart failure, although...

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Autores principales: Ghallab, Muhammad, Cancarevic, Ivan, Noff, Nicole C, Miller, Daniel, Foster, Allison, Alagha, Zakaria, Sliem, Ashraf, Bakshi, Sanjiv
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326867/
https://www.ncbi.nlm.nih.gov/pubmed/37425527
http://dx.doi.org/10.7759/cureus.40078
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author Ghallab, Muhammad
Cancarevic, Ivan
Noff, Nicole C
Miller, Daniel
Foster, Allison
Alagha, Zakaria
Sliem, Ashraf
Bakshi, Sanjiv
author_facet Ghallab, Muhammad
Cancarevic, Ivan
Noff, Nicole C
Miller, Daniel
Foster, Allison
Alagha, Zakaria
Sliem, Ashraf
Bakshi, Sanjiv
author_sort Ghallab, Muhammad
collection PubMed
description Sarcoidosis is a multisystem disorder of unknown etiology commonly associated with hilar lymphadenopathy and granulomas. Cardiac involvement is less common; however, sarcoidosis is a known cause of restrictive cardiomyopathy. It typically presents as new-onset arrhythmias or heart failure, although cases of sudden cardiac death have been reported. We present a case of a 56-year-old male with a known history of pulmonary sarcoidosis, not on active treatment, who presented to the emergency department with a week of continuous hiccups every few seconds associated with non-exertional dyspnea. An initial computed tomography (CT) scan of the chest showed multiple stellate-like ground-glass opacities and the progression of bronchiectasis. Troponins were negative. On the initial electrocardiogram (EKG), he was found to be in atrial flutter and was admitted to the medical floor. Cardiology was consulted for suspected cardiac sarcoidosis, and they recommended transfer to the tertiary care center for further evaluation. Upon arrival, the patient underwent catheter ablation for atrial flutter and returned to sinus rhythm after the procedure. The initial nuclear scan with gallium was not suggestive of cardiac sarcoidosis. However, subsequent cardiac magnetic resonance imaging (MRI) showed cardiac involvement. Due to the high risk of arrhythmias, the patient was scheduled for implantable cardioverter defibrillator placement before discharge. The patient was given oral prednisone. The patient was discharged in stable condition, and interrogation of the device found it well functioning, and no significant arrhythmias were noted. Presentation of cardiac sarcoidosis can be variable, and any should be considered in any patient with a known history of sarcoidosis who presents with atypical symptoms above the diaphragm, such as hiccups or with new-onset arrhythmias.
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spelling pubmed-103268672023-07-08 Cardiac Sarcoidosis Presented With Hiccups: A Case Report and Literature Review Ghallab, Muhammad Cancarevic, Ivan Noff, Nicole C Miller, Daniel Foster, Allison Alagha, Zakaria Sliem, Ashraf Bakshi, Sanjiv Cureus Cardiology Sarcoidosis is a multisystem disorder of unknown etiology commonly associated with hilar lymphadenopathy and granulomas. Cardiac involvement is less common; however, sarcoidosis is a known cause of restrictive cardiomyopathy. It typically presents as new-onset arrhythmias or heart failure, although cases of sudden cardiac death have been reported. We present a case of a 56-year-old male with a known history of pulmonary sarcoidosis, not on active treatment, who presented to the emergency department with a week of continuous hiccups every few seconds associated with non-exertional dyspnea. An initial computed tomography (CT) scan of the chest showed multiple stellate-like ground-glass opacities and the progression of bronchiectasis. Troponins were negative. On the initial electrocardiogram (EKG), he was found to be in atrial flutter and was admitted to the medical floor. Cardiology was consulted for suspected cardiac sarcoidosis, and they recommended transfer to the tertiary care center for further evaluation. Upon arrival, the patient underwent catheter ablation for atrial flutter and returned to sinus rhythm after the procedure. The initial nuclear scan with gallium was not suggestive of cardiac sarcoidosis. However, subsequent cardiac magnetic resonance imaging (MRI) showed cardiac involvement. Due to the high risk of arrhythmias, the patient was scheduled for implantable cardioverter defibrillator placement before discharge. The patient was given oral prednisone. The patient was discharged in stable condition, and interrogation of the device found it well functioning, and no significant arrhythmias were noted. Presentation of cardiac sarcoidosis can be variable, and any should be considered in any patient with a known history of sarcoidosis who presents with atypical symptoms above the diaphragm, such as hiccups or with new-onset arrhythmias. Cureus 2023-06-07 /pmc/articles/PMC10326867/ /pubmed/37425527 http://dx.doi.org/10.7759/cureus.40078 Text en Copyright © 2023, Ghallab et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Ghallab, Muhammad
Cancarevic, Ivan
Noff, Nicole C
Miller, Daniel
Foster, Allison
Alagha, Zakaria
Sliem, Ashraf
Bakshi, Sanjiv
Cardiac Sarcoidosis Presented With Hiccups: A Case Report and Literature Review
title Cardiac Sarcoidosis Presented With Hiccups: A Case Report and Literature Review
title_full Cardiac Sarcoidosis Presented With Hiccups: A Case Report and Literature Review
title_fullStr Cardiac Sarcoidosis Presented With Hiccups: A Case Report and Literature Review
title_full_unstemmed Cardiac Sarcoidosis Presented With Hiccups: A Case Report and Literature Review
title_short Cardiac Sarcoidosis Presented With Hiccups: A Case Report and Literature Review
title_sort cardiac sarcoidosis presented with hiccups: a case report and literature review
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326867/
https://www.ncbi.nlm.nih.gov/pubmed/37425527
http://dx.doi.org/10.7759/cureus.40078
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