A rare case of extensive biventricular cardiac sarcoidosis with reversible torrential tricuspid regurgitation

Joseph Okafor; Alessia Azzu; Raheel Ahmed; Barbara Cassimon; Kshama Wechalekar; Athol Wells; Vasileios Kouranos; A John Baksi; Rakesh Sharma; Kaushik Guha; Rajdeep Khattar

doi:10.1007/s12350-023-03307-2

A rare case of extensive biventricular cardiac sarcoidosis with reversible torrential tricuspid regurgitation

J Nucl Cardiol. 2023 Oct;30(5):1904-1909. doi: 10.1007/s12350-023-03307-2. Epub 2023 May 31.

Authors

Joseph Okafor^{1

2}, Alessia Azzu^{3

4}, Raheel Ahmed^{3

5}, Barbara Cassimon⁵, Kshama Wechalekar^{5

6}, Athol Wells⁵, Vasileios Kouranos⁵, A John Baksi^{4

5}, Rakesh Sharma⁵, Kaushik Guha⁷, Rajdeep Khattar^{8

3

5}

Affiliations

¹ Department of Echocardiography, Royal Brompton & Harefield Hospitals, Guy's and St, Thomas' NHS Foundation Trust, London, UK. j.okafor2@rbht.nhs.uk.
² National Heart & Lung Institute, Imperial College London, Guy Scadding Building, Dovehouse St, London, SW3 6LY, UK. j.okafor2@rbht.nhs.uk.
³ National Heart & Lung Institute, Imperial College London, Guy Scadding Building, Dovehouse St, London, SW3 6LY, UK.
⁴ Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
⁵ Cardiac Sarcoidosis Service, Royal Brompton & Harefield Hospitals, Guy's and St, Thomas' NHS Foundation Trust, London, UK.
⁶ Department of Nuclear Medicine and PET, Royal Brompton & Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
⁷ Department of Cardiology, Portsmouth Hospitals University Trust, Portsmouth, UK.
⁸ Department of Echocardiography, Royal Brompton & Harefield Hospitals, Guy's and St, Thomas' NHS Foundation Trust, London, UK.

Abstract

Reversal of torrential tricuspid regurgitation is rarely seen. We describe a case in which effective immunosuppression alongside conventional heart failure therapies lead to reversibility of torrential tricuspid regurgitation in a patient with cardiac sarcoidosis. We also discuss the diagnostic challenge in distinguishing cardiac sarcoidosis from other myocardial diseases in a patient presenting with biventricular failure.

Keywords: MRI; PET; Sarcoid heart disease; amyloid heart disease; echo; valvular heart disease.

Publication types

Case Reports

MeSH terms

Cardiomyopathies* / complications
Cardiomyopathies* / diagnostic imaging
Heart Failure*
Humans
Myocarditis*
Sarcoidosis* / complications
Sarcoidosis* / diagnostic imaging
Tricuspid Valve Insufficiency* / complications
Tricuspid Valve Insufficiency* / diagnostic imaging