Atrial fibrillation as the initial clinical manifestation of cardiac sarcoidosis: a case report and review of the literature.

Cardiac sarcoidosis is an unusually rare form of sarcoidosis that often remains silent clinically; although if not screened for and diagnosed early can lead to disastrous consequences, which include sudden death. In addition to sudden death, cardiac sarcoidosis can present with myriad manifestations, including congestive heart failure and conduction blocks, as well as atrial or ventricular arrhythmias. We hereby present a case report of 45-year-old African-American male who repeatedly presented in the emergency room with episodes of paroxysomal supraventricular tachycardia (PSVT) as well as atrial fibrillation of unknown origin. Detailed workup led to a successful diagnosis of cardiac sarcoidosis, which is being treated with 1 mg/kg of steroids daily. Our focus on this report is that with recent advances in imaging technology, cardiac sarcoidosis can be detected more easily than before. Therefore, a high degree of clinical suspicion and systematic evaluation to uncover the cardiac involvement is warranted to improve outcomes of patients with sarcoidosis and cardiac involvement.