Unusual cardiovascular manifestations of sarcoidosis, a report of three cases: coronary artery aneurysm with myocardial infarction, symptomatic mitral valvular disease, and sudden death from ruptured splenic artery

BackgroundCardiac and vascular involvement by sarcoid is only rarely recognized clinically. Involvement of muscular arteries such as epicardial coronaries or the splenic artery has not been previously reported in these patients, and valvular disease has been reported only rarely.MethodsWe present herein clinical, imaging and pathologic documentation of three such patients, each displaying one of these unusual manifestations and enlarging the spectrum of cardiac sarcoid.ResultsThe presentations were life threatening, one with myocardial infarction caused by a coronary artery aneurysm, a second with splenic artery rupture and hemorrhage, and the third with severe mitral regurgitation. The clinical and histopathologic findings are described and a review of the literature is undertaken.