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Semin Respir Crit Care Med 2002; 23(6): 513-528
DOI: 10.1055/s-2002-36516
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Cardiac Involvement in Sarcoidosis

Jane C. Deng1 , Robert P. Baughman2 , Joseph P. Lynch III1
  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan
  • 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio
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Publication History

Publication Date:
07 January 2003 (online)

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ABSTRACT

Cardiac sarcoidosis is a challenging diagnostic entity. Manifestations range from an incidentally discovered, benign condition to fatal cardiomyopathy and arrhythmias. In this review, we discuss the salient clinical features, diagnostic evaluation, treatment, and prognosis of cardiac sarcoidosis. A definitive histologic diagnosis of myocardial sarcoidosis is difficult, and treatment may be necessary in some patients with suspected cardiac involvement even in the absence of histologic confirmation. Optimal strategies to diagnose cardiac involvement have not been clarified. Thallium201 radionuclide scintigraphy has been most extensively studied; 2-D echocardiography is less sensitive, but may have a complementary role. Additional radionuclide techniques (e.g., gallium67 or technetium 99 ) may have a role in complex cases. Given the life-threatening nature of cardiac involvement, prompt and aggressive treatment with corticosteroids or immunosuppressive agents, or both, is warranted. Long-term, possibly lifelong, therapy may be required. Serious, recurrent tachyarrhythmias may require implantation of an automatic cardioverter-defibrillator. Recognizing cardiac sarcoidosis and selecting a sensible management strategy remain the major obstacles facing clinicians.

KEYWORD

Sarcoidosis - cardiac - myocardial - arrhythmias - sudden death

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