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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 2, March/April 2015
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AFRICA
life-threatening condition, is probably an underdiagnosed disease,
as cardiac involvement is clinically apparent in only about 5% of
all patients, while cardiac granulomas are found in about 25% of
patients with sarcoidosis who are examined at autopsy.
3
Cardiac
sarcoidosis may occur without apparent disease in other organs.
It has been reported to occur most frequently in middle-aged
or older women in Japan, although its incidence in Western
countries was shown to have no gender difference and to be
higher in the younger generation.
4,5
Sarcoidosis in pregnancy
The incidence of sarcoidosis in pregnancy is estimated to be
0.02 to 0.05%.
6
Maternal sarcoid symptoms may improve during
pregnancy but may be more severe after delivery. The changes
in the severity of sarcoidosis during pregnancy are possibly due
to increased serum steroid levels, which rapidly decrease after
delivery.
7
On the other hand, sarcoidosis can progress during
pregnancy, or as our two cases show, manifest for the first
time during pregnancy. Sudden death secondary to ventricular
Fig. 2.
Cardiac MRI images of case 1. A: basal short-axis T2W slice, demonstrating patchy high signal of the inferoseptal myocar-
dium (white arrow). B: basal short-axis T1W early post-gadolinium image, revealing inhomogeneous myocardial enhance-
ment (white arrow). C and D: basal (C) and mid-ventricular (D) short-axis phase-sensitive inversion recovery (PSIR) delayed
enhancement images, demonstrating anterior basal (black arrow in C) as well as inferoseptal epicardial enhancement (white
arrows in C and D).
A
C
B
D