Cardiac Sarcoidosis Mimicking Anterior Myocardial Infarction.

A 58-year-old asymptomatic man with electrocardiogram (ECG) abnormality was referred to our institution for cardiac exams. His ECG showed a bifascicular block, and the echocardiography demonstrated a wall motion abnormality in apex. Stress-rest myocardial perfusion imaging (MPI) showed a significant defect in anterior wall with partial redistribution at rest. He was suspected of having an anterior myocardial infarction (MI) and underwent cardiac catheterization. However, coronary angiography (CAG) revealed no significant coronary atherosclerosis. Cardiovascular magnetic resonance imaging (CMR) was performed to evaluate the extent of myocardial infarction. Late gadolinium enhancement (LGE) demonstrated a significant epicardial and midmyocardial LGE in the multiple site including anterior, anteroseptal, lateral, inferior wall, and basal right ventricle junction, which strongly indicated that the fibrosis was due to cardiac sarcoidosis (CS).A myocardial perfusion defect in anterior wall shown in the MPI revealed the fibrosis as an atypical finding mimicking anterior MI.