Steroid therapy in cardiac sarcoidosis. Increased left ventricular contractility concomitant with electrocardiographic improvement after prednisolone.

A 23-year-old woman was referred to our clinic because of pulmonary edema. The electrocardiogram on admission demonstrated eventual QS pattern in leads 1 and a VL with a poor progression of the R-wave amplitude in the precordial leads. The left ventricle was remarkably dilated with severely diminished contractility. Biopsy of the inguinal lymph nodes, liver, and myocardium confirmed the diagnosis of generalized sarcoidosis. After administration of prednisolone, the left ventricular dimension decreased, and contractility increased concomitant with an improvement of the electrocardiographic abnormalities without any aneurysm forming. We conclude that steroids may keep some jeopardized myocardium viable and that initiation of steroid therapy in an early phase does not result in formation of an aneurysm.