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Diagnosis of Cardiac Sarcoidosis Through Mismatched Defects Seen on N-13 NH3/F-18 FDG Cardiac PET

Chen, Stuart, MD; Bokhari, Sabahat, MD

doi: 10.1097/RLU.0b013e3182336113
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A 52-year-old man with asymptomatic pulmonary sarcoidosis was referred for fatigue and lightheadedness culminating in syncope. He underwent right heart catheterization with endomyocardial biopsy that did not show evidence of sarcoidosis or other infiltrative disease. Subsequent cardiac N-13 NH3 and F-18 FDG PET revealed perfusion-metabolism mismatched defects, defined as areas of increased metabolism and concurrent decreased perfusion, in the anterior and inferior cardiac walls. He was diagnosed with active cardiac sarcoidosis and initiated on high-dose corticosteroids with significant improvement in symptoms.

From the Division of Cardiology, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY.

Received for publication April 11, 2011; revision accepted August 8, 2011.

Conflicts of interest and sources of funding: none declared.

Reprints: Stuart Chen, MD, New York-Presbyterian/Columbia, 575 West 181st Street, New York, NY 19932. E-mail:

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.