Cardiac sarcoidosis

This is a 19-years old boy who presented with supraventricular tachycardia. After his rhythm was stabilized, he came for an MRI.

The CMR shows areas of patchy mid-myocardial enhancement (Figs. 1 & 2), which are by themselves non-specific. This pattern is non-ischemic, but may occur with many conditions causing inflammation or scarring. The patient however also had non-necrotic mediastinal adenopathy (Fig. 3), which suggested the possibility of sarcoidosis. A biopsy of the subcarinal node showed non-caseating granulomatous disease.