A rare case of pericardial sarcoidosis presenting as chest pain

TL;DR

A rare case of pericardial sarcoidosis is presented, highlighting the importance of advanced imaging and timely treatment for improved outcomes.

Contribution

This case study adds to the limited literature on pericardial sarcoidosis by presenting a detailed clinical course and successful treatment approach.

Findings

A 52-year-old woman with subacute chest pain was diagnosed with pericardial sarcoidosis.

Treatment with steroids and methotrexate led to clinical improvement and near resolution of the disease.

The case underscores the need for advanced imaging and biopsy in diagnosing rare cardiac sarcoidosis.

Abstract

Pericardial sarcoidosis is an uncommon cause of chest pain to consider, and it requires a heightened level of suspicion and thorough history gathering. If there is suspicion of inflammatory disease, pursuing advanced imaging and biopsies is crucial, as early immunosuppressive treatment can enhance outcomes.

Pericardial involvement in sarcoidosis is a rare condition with limited research. This case study discusses a 52‐year‐old African American woman who presented with subacute chest pain and was diagnosed with pericardial sarcoidosis. Diagnostic evaluation revealed extensive lymphadenopathy and pericardial effusion, and a pericardial biopsy confirmed non‐caseating granulomatous inflammation. Treatment with steroids and methotrexate resulted in clinical improvement. Eight months follow‐up showed near resolution of pericardial disease. This case emphasizes the importance of considering cardiac sarcoidosis in sarcoidosis patients, utilizing advanced imaging for accurate diagnosis, and tailoring treatment to the level of cardiac involvement.

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