PMC6350583_01
Brain magnetic resonance image showing neurosarcoidosis involving the hypothalamus and pituitary.
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A 40-year-old African-American male with neurosarcoidosis involving the hypothalamus and pituitary (Figure 1) presented to an urban academic medical center with altered mental status.
(a) Electrocardiogram at 32 C revealing sinus bradycardia with premature atrial contractions, Osborn waves most prominent in the precordial lateral leads, prolonged PR and QT intervals. (b) Electrocardiogram after initiation of treatment reveals an increase in heart rate to 60 beats per minute and an improvement of the PR (210 ms), QRS (98 ms), and QT (QTc 432 ms) intervals.
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Admission ECG revealed sinus bradycardia at 41 beats per minute, first-degree AV block (PR interval 280 ms), premature atrial contractions, prolonged QRS (160 ms) and QT (QTc 584 ms) intervals, and Osborn waves most prominent in the precordial lateral leads (Figure 2(a)). The patient was warmed via external warming blankets, with resolution of the above electrocardiographic findings (Figure 2(b)).