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Chasing the ACE of hearts
  1. Andrew D'Silva1,
  2. Imad Jassim2,
  3. John Greenwood3,
  4. Konrad Grosser2
  1. 1Conquest Hospital, St Leonards-on-Sea, East Sussex, UK
  2. 2Department of Cardiology, Queen Elizabeth Queen Mother Hospital, Margate, Kent, UK
  3. 3Department of Cardiology, Leeds General Infirmary, Leeds, West Yorkshire, UK
  1. Correspondence to Dr Andrew D'Silva, adsilva{at}


A case study of a patient presenting with acute pulmonary oedema, dynamic ECG changes and a rise in cardiac biomarkers with no evidence of myocardial infarction. The clinical course followed a dynamic and inflammatory disease process with evidence of sarcoidosis on tissue histology. The patient had an excellent clinical response to corticosteroid therapy with minimal evidence of hyperenhancement (focal fibrosis) on cardiac MRI at 6 months. The case highlights the challenges in making a new diagnosis of sarcoidosis where involvement appears limited to the heart and lymphatic system.

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