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Introduction: Sarcoidosis is a multisystem, granulomatous disease of unknown origin. In a few cases, cardiac sarcoidosis appears before systemic sarcoidosis. Cardiac sarcoidosis accounts for 25% of deaths from the disease. The antemortem diagnosis of cardiac sarcoidosis can be challenging due to the variable clinical presentations. Case Report: We report a case of primary cardiac sarcoidosis which involved the epicardial myocardium initially. For quit long, large ST-segment elevation was the only sign of sarcoidosis in the completely symptom-free patient. Conclusion: Persistent ST-segment elevation could be the first sign of cardiac sarcoidosis.

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