Chest
ReviewMyocardial Sarcoidosis
Section snippets
SARCOID LESION
The basic lesion of sarcoidosis is a noncaseating granuloma consisting of pale-pink epithelioid cells, occasional multinucleate giant cells, and a scanty rim of lymphocytes. Caseation is absent; occasionally fibrinoid necrosis may be seen, particularly in the areas where several granulomas have coalesced, and may be distinguished from caseation by the presence of a fine reticulin pattern on silver staining. In cardiac sarcoidosis the granulomas may be confluent and extensive or may be
CLINICAL PATTERNS OF CARDIAC DYSFUNCTION
The clinical manifestations depend on the location and extent of involvement of the myocardial tissue.
Awareness of the Problem
When confronted with complex and undiagnosed arrhythmias, conduction disease, or congestive heart failure in a young or middle-aged person, the clinician should consider the possibility of sarcoid heart disease. Diagnosis depends on recognizing the multisystem nature of sarcoidosis and then seeking histologic proof of the pathology either in the myocardium or in other organs.32, 33
Physical Examination
The physician should seek out evidence of other organ system involvement, including lymphadenopathy, hepatomegaly,
TREATMENT OF CARDIAC SARCOIDOSIS
The specific therapy depends on the mode of presentation.
PROGNOSIS IN CARDIAC SARCOIDOSIS
Roberts and associates9 concluded that after the development of cardiac symptoms and signs, the survival in most patients was limited to about two years. According to Fleming69 the prognosis is not nearly so disastrous; over 100 of his patients have survived more than 5 years, 36 for more than 10 years, and 7 for more than 20 years. The major causes of death include sudden death due to ventricular tachyarrhythmias or conduction block and congestive heart failure.70, 71, 72 Early diagnosis and
REFERENCES (72)
- et al.
The heart in sarcoidosis
Chest
(1971) - et al.
Cardiac sarcoidosis: a potentially treatable form of myocarditis
Mayo Clin Proc
(1985) - et al.
Sarcoidosis of the heart presenting with ventricular tachycardia and atrioventricular block
Am J Cardiol
(1971) - et al.
Cardiac sarcoidosis with sudden death: treatment with automatic implantable cardioverter defibrillator
Am Heart J
(1988) Sarcoidosis of the cardiac conducting system
Am Heart J
(1979)- et al.
Pericardial effusion in sarcoidosis
Chest
(1979) - et al.
Cardiac tamponade as the presenting symptom of sarcoidosis
Am Heart J
(1985) - et al.
Transmission of sarcoidosis via cardiac transplantation [letter]
Lancet
(1990) - et al.
Taliercio CP Two-dimensional echocardiographic findings in systemic sarcoidosis
Am J Cardiol
(1989) - et al.
Echocardiographic evaluation of patients with systemic sarcoidosis
Am Heart J
(1985)
Utility of endocardial biopsy in the diagnosis of cardiac sarcoidosis
Chest
Steroid therapy in cardiac sarcoidosis: increased left ventricular contractility concomitant with electrocardiographic improvement after prednisone
Chest
Myocardial sarcoidosis unresponsive to steroids: treatment with cyclophosphamide
Chest
Baughman RP The use of low dose methotrexate on refractory sarcoidosis
Am J Med
Cyclosporine and chronic sarcoidosis
Chest
Sarcoid of the myocardial septum with complete heart block: report of two cases
Am Heart J
Antiarrhythmic therapy guided by programmed electrical stimulation in cardiac sarcoidosis with ventricular tachycardia
Am Heart J
Ventricular aneurysm due to cardiac sarcoidosis with surgical cure of refractory ventricular tachycardia
Am J Cardiol
Sudden death behind the wheel from natural disease in drivers of four wheeled motorized vehicles
Am J Cardiol
Sharma OP Myocardial sarcoidosis
Sarcoidosis
Boeck's sarcoid: report of case with visceral involvement
Arch Intern Med
Uber Reisenzellengranulome bei zwei fallen von endocardiofibrose
Beitr Pathol Anat
Sarcoid heart disease
N Engl J Med
Clinicopathological study of fatal myocardial sarcoidosis
Ann NY Acad Sci
Cardiac sarcoid: a clinicopathological study of 84 unselected patients with systemic sarcoidosis
Circulation
Sarcoid heart disease
Sarcoidosis
Sarcoidosis of the heart: a clinicopathologic study of 35 necropsy patients (group I) and review of 78 previously described necropsy patients (group II)
Am J Med
Sarcoid heart disease
Br Heart J
Myocardial sarcoidosis
Br Heart J
Long term prognosis of cardiac sarcoidosis with permanent pacemaker implantation: a Japanese Study
Sarcoidosis and the heart
Pathol Annu
Systemic sarcoidosis with refractory ventricular tachycardia and heart failure
Br Heart J
Ventricular tachyarrhythmia due to cardiac sarcoidosis in a child
Pediatrics
Clinical and histological profile of sarcoidosis of the heart and acute idiopathic myocarditis: concepts through a study employing myocardial biopsy
Jpn Circ J
Cardiac sarcoidosis
Semin Respir Med
Anginal chest pain in sarcoidosis
Thorax
Cited by (230)
Evaluation and Management of Cardiac Sarcoidosis with Advanced Imaging
2023, Heart Failure ClinicsImpact of respiratory gating and ECG gating on <sup>18</sup>F-FDG PET/CT for cardiac sarcoidosis
2023, Journal of Nuclear CardiologyPhenotypic and HLA-DRB1 allele characterization of Swedish cardiac sarcoidosis patients
2022, International Journal of CardiologyNon-steroidal treatment of cardiac sarcoidosis: A systematic review
2021, IJC Heart and VasculatureThe utility of endobronchial ultrasound-transbronchial needle aspiration in patients with suspected extra-pulmonary sarcoidosis without thoracic lymphadenopathy
2020, Respiratory MedicineCitation Excerpt :The most common extra-pulmonary organs involved are skin, lymph nodes, eyes and liver [2,3]. Cardiac and neurologic involvement are less frequent [1,2,4–9]. The diagnosis of these extra-pulmonary manifestations can be difficult due to a wide differential diagnosis and nonspecific features of testing, so tissue confirmation is often necessary.