Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 65 year-old female had a node of some kind in her right leg five years ago and was diagnosed with sarcoidosis by gallium scintigraphy. Serum angiotension-converting enzyme levels had gradually increased, and three months ago she felt palpitations and dizziness when standing. On electrocardiogram, 2:1 atrioventricular (AV) block was observed. On transthoracic echocardiogram, the basal portion of the interventricular septum (IVS) revealed wall thinning with dyskinetic motion and lack of systolic thickening, and low attenuation. The basal portion of the left ventricular (LV) posterior inferior wall revealed mild wall thickening with low attenuation. Enhanced multislice-CT revealed a thickened LV posterior wall and thinned basal portion of IVS with interstitial change suggesting presence of fibrosis or edema. Late enhancement was also observed in the basal portion of the LV posterior inferior wall and basal IVS in T1 weighted magnetic resonance imaging (MRI); in addition, an area, the center of which indicated low attenuation surrounded by high attenuation, was observed in the basal portion of the LV posterior inferior wall in T2 weighted MRI. Positron emission tomography (PET) imaging using F-18 fluoro-deoxyglucose with the subject fasted for 6 h beforehand, revealed strong uptake in the basal portion of IVS and a thickened LV posterior wall, suggesting the presence of inflammation. Administration of predonisolone was started before pacemaker implantation and clinical symptoms immediately disappeared; in addition AV block recovered to normal sinus rhythm. On a repeat MRI performed four months later, the late enhancement in T1 weighted MRI and the high attenuation surrounding low attenuation in the basal portion of the LV posterior inferior wall in T2 weighted MRI both disappeared, and we confirmed that temporary edema had also disappeared.
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PMID:Cardiac sarcoidosis complicated with atrioventricular block and wall thinning, edema and fibrosis in left ventricle: confirmed recovery to normal sinus rhythm and visualization of edema improvement by administration of predonisolone. 1954 5

We report a case of sudden marked deterioration of ventricular stimulation threshold resulting in pacemaker failure 16 months after a ventricular septal lead implantation for atrioventricular block. Echocardiography revealed septal wall thinning at the electrode-tissue interface, which was not detected pre-operatively. Endomyocardial biopsy confirmed cardiac sarcoidosis. The increased threshold was reversible with prednisolone.
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PMID:Sudden reversible pacemaker failure in a patient with cardiac sarcoidosis: an unfortunate case of ventricular septal pacing. 2227 41

We herein present a case of cardiac sarcoidosis with atrioventricular (AV) block that was evaluated using magnetic resonance imaging (MRI) before and after pacemaker implantation. An echocardiogram showed wall thinning in the basal septum. MRI showed late gadolinium enhancement in the interventricular septum and right ventricle. Fluorine-18-fluorodeoxyglucose positron emission tomography (PET) demonstrated abnormal uptake in the same area. An MR-conditional pacemaker was implanted to treat AV block. Steroid treatment resulted in the remission of the cardiac lesions and AV block, as confirmed by PET and MRI. MR-conditional pacemakers are thus considered to have great advantages in treating cardiac sarcoidosis with AV block.
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PMID:Clinical utility of a magnetic resonance-conditional pacemaker in a patient with cardiac sarcoidosis. 2377 44

Generally, low left ventricular ejection fraction (LVEF) is a risk for ventricular arrhythmia in patients with cardiac sarcoidosis. We present a case of cardiac sarcoidosis with preserved LVEF that evoked ventricular fibrillation (VF). A 73-year-old woman with VF presented to our emergency department. She had a history of ocular sarcoidosis, with gradual thinning of the basal intraventricular septum. LVEF was 62% on the most recent echocardiography. The electrocardiogram after defibrillation showed complete atrioventricular block (CAVB) with QT segment prolongation and frequent ventricular premature beats. VF via torsade des pointes (TdP) was suspected, and temporary intravenous ventricular pacing and magnesium sulfate infusion suppressed her VF. Cardiac sarcoidosis was diagnosed, and an implantable cardioverter defibrillator was implanted. Patients with cardiac sarcoidosis with CAVB are at risk of evoking VF via TdP regardless of LVEF. If cardiac sarcoidosis is suspected, early diagnosis and risk stratification of ventricular arrhythmia are important.
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PMID:Ventricular fibrillation via torsade des pointes of cardiac sarcoidosis with preserved left ventricular ejection fraction. 2779 80

Fluorine-18 fluorodeoxygluose (18F-FDG) positron emission tomography (PET) is a useful tool for evaluating disease activity in sarcoidosis including cardiac involvement. A 67-year-old patient who developed atrioventricular block requiring permanent pacemaker implantation was diagnosed with cardiac sarcoidosis. The patient did not undergo steroid or immunosuppressive therapy but underwent serial 18F-FDG PET examination, which showed spontaneous reduction in the myocardial FDG uptake, indicating the remission of immune-inflammatory activity. Although the global systolic function remained preserved, thinning of the septal wall emerged during the clinical course of follow-up, which is characteristic for cardiac sarcoidosis.
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PMID:Spontaneous Reduction in Abnormal Myocardial Uptake of Fluorine-18 Fluorodeoxygluose in a Patient with Cardiac Sarcoidosis. 2968 78

A 74-year-old female was admitted for the treatment of complete atrioventricular block. Echocardiography showed thickening of interventricular septum and a slight thinning in the basal region with normal left ventricular (LV) function. She was clinically diagnosed with cardiac sarcoidosis accompanied by active inflammation from the findings of blood test, nuclear scanning, and magnetic resonance imaging. After pacemaker implantation, we recommended corticosteroid therapy, which she refused for the fear of side effects. Three years later, she was re-admitted to our hospital due to heart failure. Echocardiography showed severe LV systolic dysfunction and dilatation with wall thinning. Even though we started corticosteroid therapy and continued it for one year, LV function was not improved. In patients with cardiac sarcoidosis accompanied by active inflammation, LV dysfunction, and dilatation may rapidly progress. Early diagnosis and treatment with corticosteroid may be important to preserve cardiac function. <Learning objective: Left ventricular (LV) dysfunction in patients with cardiac sarcoidosis accompanied by active inflammation may rapidly progress in a short period. Corticosteroid therapy is demonstrated to improve the long-term clinical outcome, however, it may not be effective once LV function is worsened with wall thinning. Early diagnosis and treatment with corticosteroid may be important to preserve cardiac function in patients with cardiac sarcoidosis accompanied by active inflammation.>.
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PMID:Untreated cardiac sarcoidosis with active inflammation: Severe left ventricular dysfunction and ventricular wall thinning in three years. 3027 19


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