Background: Primary cardiac sarcoidosis (CS) is rare, and concomitant involvement of the coronary arteries is rarer still. Successful diagnosis of this disease is difficult due to its nonspecific symptoms which mimic those of idiopathic dilated cardiomyopathy (IDCM).
Methods and results: We describe a 47-year-old Caucasian male who underwent orthotopic heart transplant for presumed IDCM. Examination of the explanted heart revealed numerous nonnecrotizing granulomata throughout, similar granulomata in the walls of the large coronary arteries, and large areas of fibrosis.
Conclusions: In cases of IDCM with symptoms of angina or acute coronary syndrome, the possibility of CS should be considered. Herein, we present this case and a review of the relevant literature.