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01.08.2008 | CME Weiterbildung • Zertifizierte Fortbildung

Kardiale Sarkoidose

verfasst von: Dr. S. Pabst, I. Tuleta, C. Grohé

Erschienen in: Die Kardiologie | Ausgabe 4/2008

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Zusammenfassung

Die Sarkoidose ist eine systemisch granulomatöse Erkrankung ungeklärter Ätiologie, die histologisch durch nicht verkäsende Granulome charakterisiert ist. Zu den Prädilektionsorganen gehören Hiluslymphknoten, Lunge, Auge und Haut. Allerdings können auch andere Organe wie Herz, Leber, Milz, Knochen, Muskeln und nichtpulmonale Lymphknoten betroffen sein. Eine kardiale Beteiligung ist relativ selten, verschlechtert die Prognose jedoch deutlich. Die häufigsten klinischen Manifestationen einer kardialen Sarkoidose umfassen neben einer Herzinsuffizienz ventrikuläre Arrhythmien. Auch Fälle von einem plötzlichen Herztod sind bekannt. Das Fehlen einer klinischen Symptomatik schließt eine kardiale Manifestation der Sarkoidose nicht aus, da die meisten Fälle erst post mortem erkannt werden. Die Diagnose basiert auf einer Reihe von Untersuchungen wie Elektrokardiographie, Echokardiographie, nuklearmedizinischen Untersuchungen, Magnetresonanztomographie, Koronarangiographie, endomyokardialer Biopsie und elektrophysiologischen Untersuchungen. Häufig sind die Befunde nicht zielführend, und erst das Ansprechen auf eine gezielte Therapie ist die einzige Bestätigung der Verdachtsdiagnose. Zu den therapeutischen Optionen zählen eine medikamentöse Behandlung mit Immunsuppressiva und eine spezifische kardiale Medikation sowie eine Schrittmacher- oder Defibrillatorimplantation. Bei Versagen dieser Therapieformen ist die Herztransplantation als Ultima Ratio eine Option.
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Metadaten
Titel
Kardiale Sarkoidose
verfasst von
Dr. S. Pabst
I. Tuleta
C. Grohé
Publikationsdatum
01.08.2008
Verlag
Springer-Verlag
Erschienen in
Die Kardiologie / Ausgabe 4/2008
Print ISSN: 2731-7129
Elektronische ISSN: 2731-7137
DOI
https://doi.org/10.1007/s12181-008-0087-8

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