Cardiac sarcoidosis concealed by arrhythmogenic right ventricular dysplasia/cardiomyopathy.

BACKGROUND: A 37-year-old male with a history of palpitations and ventricular tachycardia was diagnosed with arrhythmogenic right ventricular dysplasia/cardiomyopathy on the basis of clinical assessment, electrocardiography and echocardiography. Over the following 3 years the patient progressed to end-stage heart failure and eventually underwent heart transplantation. Histological analysis of the explanted heart revealed the presence of numerous noncaseating granulomas. INVESTIGATIONS: Electrocardiography, echocardiography, 24 h Holter monitoring, cardiac MRI, coronary angiography, endomyocardial biopsy, exercise testing, electrophysiological study, laboratory examinations and histological examination of the explanted heart. DIAGNOSIS: Cardiac sarcoidosis. MANAGEMENT: Immunosupressive and corticosteroid therapy. Routine endomyocardial biopsy is planned.