A 37-year-old African American woman experienced multiple presyncopal and syncopal episodes over the course of 1 to 2 weeks. She twice presented to a local emergency department, where she was given lorazepam and discharged to home. On the morning of admission to our emergency department, the patient presented with pleuritic chest pain, dizziness, and shortness of breath.
Her medical history was notable for asthma and atopic dermatitis, but she denied any prior cardiac disease, joint pains, or visual disturbances. She did report a long history of facial, neck, and arm lesions, which recently had become more prominent and pruritic. Her only medication at the time of admission was an albuterol inhalant.
Ford PG, Jorizzo JL, Hitchcock MG. Previously Undiagnosed Sarcoidosis in a Patient Presenting With Leonine Facies and Complete Heart Block. Arch Dermatol. 2000;136(6):712-714. doi:10.1001/archderm.136.6.712