case_images: PMC10050710_01
case_images: Key investigations performed. (A) Electrocardiogram showing atrial fibrillation with rapid ventricular response. There was no significant ST segment or T wave change. (B) Coronary angiogram showed no obstructive coronar artery disease. (C) Positron emission tomography and computed tomography (PET-CT) showed lymphadenopathy over cervical, bilateral axillary, mediastinal, hilar, porta hepatis, and peripancreatic areas. (D) Cardiac strain analysis performed prior to discharge from hospital showed nearly normalized LVEF of 57.5% and global longitudinal strain (GL) of -17.5%. Decreased segmental longitudinal strain in anterior, anteroseptal, inferoseptal, and posterior from basal to mid level, and decrease in layer-specific strain from epicardial to mid-myocardial were observed.
case_images: fcvm-10-1066699-g0001.jpg
case_images: PMC10050710_01_fcvm-10-1066699-g0001.jpg
case_images: F1
case_images: T wave change (Figure 1A). Troponin T peaked at 7,000 ng/ml and B-type natriuretic peptide (BNP) was grossly elevated to >26,000 pg/ml. DCoronary angiography revealed no obstructive coronary artery disease (Figure 1B). No malignancy, infective foci, or systemic feature of sarcoidosis was found (Figure 1C). Segmental longitudinal strain of the anterior, anteroseptal, inferoseptal, and posterior walls at the basal and middle level remained decreased, as did the layer-specific strain from the epicardium to mid-myocardium (Figure 1D).