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Pericardial Involvement Frequently Complicating Pulmonary and/or Systemic Sarcoid Granulomatosis: A Lifelong, Multistage Disease, Periodical Study in 278 Biopsy-Proven Patients FREE TO VIEW

Ioannis Angomachalelis*, PhD; George Kyriazis, PhD; Nestor Angomachalelis, PhD
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Aristotle University of Thessaloniki, School of Medicine, Thessaloniki, Greece

Chest. 2012;142(4_MeetingAbstracts):449A. doi:10.1378/chest.1388984
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PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: :Nearly 21% of pulmonary and/or systemic Sarcoidosis (S) patients (pts) appeared developing pericardial involvement in their initial Hospital admission.This study investigates evaluation of the total ,multi stage,pericardial effusion frequency (P.Ef),not well established and reported in the literature.

METHODS: 178/278 biopsy-proven ,pulmonary and/or systemic Sarcoidosis Pts,56 males and 122 females,mean age 47,8 yrs,were free of other clinical cardiovascular pathology and investigated for the possible development of the multi-stage,symptomatic or latent,pericardial granulomatosis.Further to clinical examination,ECG,pulmonary function,blood tests and blood gases,patients underwent periodical echocardiography and occasionally radionuclide myocardial scintigraphy by Technetium-99m-Pyrophosphate(Tc-99m-pyp).

RESULTS: :The results Showed 1.Total, multi-stage,pericardial effusion in 49% Pts 2. Usually latent and small to moderate frequency of pericardial constriction 3. Pericardial effusion concomitant with abnormal radionuclide myocardial imaging in 42% Pts 4. Asymmetric Septal Hypertophy (ASH) coincident with abnormal myocardial scan in 21,5% Pts 5. Confirmed Sudden Cardiac Death(SCD) cases by the present study only appeared in 1,3% Pts undergoing corticosteroid therapy.

CONCLUSIONS: : 1) Pericardial effusion in 49% Pts totally,evaluated periodically, indicates an unexpected frequent percentage of pericardial involvement appearing in multi-various stage of life-long sarcoid granulomatosis,which has never been previously well established and reported in the literature 2) Pericardial effusion coincident with abnormal myocardial scan could be compatible with the presence of myo-pericardial involvement in 42% Pts 3) ASH,mimicking hypertrophic cardiomyopathy and co-existed with abnormal cardiac scintigraphy was presumably due to sarcoid cardiomyopathy in 21,5% Pts 4. Latent pericardial constriction could be responsible for the unexplained dyspnea and chest tideness 5)Unlike the literature, the surprising low percentage of sudden cardiac death cases(1,3%) confirmed by the present study, were possibly considered relating to long term corticosteroid treatment.

CLINICAL IMPLICATIONS: : Due to frequent pericardial and myo-pericardial involvement,followed sometimes by pericardial constriction and often arrhythmias,sarcoidosis Pts should be followed up periodically in all disease stages and undergo proper therapy.

DISCLOSURE: The following authors have nothing to disclose: Ioannis Angomachalelis, George Kyriazis, Nestor Angomachalelis

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Aristotle University of Thessaloniki, School of Medicine, Thessaloniki, Greece




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