Infiltrating cardiomyopathy presenting with recurrent ventricular tachycardia

Abstract

Abstract Infiltrative cardiomyopathy (ICM) refers to a heterogeneous group of myocardial disorders mainly cardiac amyloidosis, sarcoidosis, and hemochromatosis with characteristic deposition of abnormal substances within cellular and intercellular spaces, which leads to the development of ventricular diastolic dysfunction, systolic dysfunction, or both. Sarcoidosis is a multisystem, granulomatous disease of unknown etiology. Accumulating evidence suggests that it is caused by an immunological response to an unidentified antigenic trigger in genetically susceptible persons. Cardiac sarcoidosis is a manifestation of sarcoidosis that is challenging to diagnose due to its clinical silence. The consequences of cardiac sarcoidosis include conduction defects, arrhythmias, cardiomyopathy, congestive heart failure, and sudden cardiac death (SCD). This case describes a 45-year-old female with a history of recurrent ventricular tachycardia in a patient previously diagnosed as dilated nonischemic cardiomyopathy. Who was later diagnosed as ICM, most probably cardiac sarcoidosis with the help of cardiac magnetic resonance imaging (MRI). Initial testing for infiltrating cardiomyopathy should include echocardiography, cardiac MRI, and fluorodeoxyglucose–positron emission tomography study. Treatment focuses on optimizing heart failure therapy and placement of a biventricular implantable cardioverter-defibrillator for primary prevention of SCD.