Atrioventricular Block Revealing a Cardiac Sarcoidosis in Young Adult Patient

Abstract

Sarcoidosis is a multisystem granulomatous disease of unknown aetiology, and while cardiac involvement is uncommon, it can be life-threatening. Cardiac sarcoidosis may be asymptomatic or manifest through conduction disturbances, arrhythmias, or heart failure. The case of a 34-year-old man admitted for recurrent syncopal episodes and near-fainting spells was reported. Electrocardiogram revealed a second-degree atrioventricular block (2:1) with bradycardia. Chest radiography showed bilateral hilar lymphadenopathy, and further investigations, including thoracic computed tomography and cardiac magnetic resonance imaging, confirmed the diagnosis of sarcoidosis with cardiac and mediastinal-pulmonary involvement. The patient underwent dual-chamber pacemaker implantation and was started on corticosteroid therapy, resulting in a favourable clinical evolution. This case highlights the importance of considering cardiac sarcoidosis in young patients with unexplained atrioventricular block and the role of advanced cardiac imaging in establishing the diagnosis and guiding timely management.