Cardiac sarcoidosis – management and prognosis (RCD code: III‑3A.3)

Abstract

Sarcoidosis is a systemic, granulomatous disease of unknown etiology. Cardiac involvement in the course of sarcoidosis occurs in 5% of patients. However, about 25% of patient with systemic/pulmonary sarcoidosis might present with asymptomatic myocardial injury. The main manifestations of cardiac sarcoidosis are conduction abnormalities, ventricular arrhythmias and heart failure. Diagnosis of cardiac sarcoidosis remains a challenge for physicians. Treatment should be introduced at the time of diagnosis to prevent potentially lethal progression of cardiac disease. Steroids are the first drugs of choice. Additional anti‑sarcoidosis agents are used as alternatives or to reduce the steroids dose. Some patients require implantation of a cardioverter‑defibrillator for the prevention of sudden cardiac death. Patients with refractory ventricular tachyarrhythmia or severe, intractable heart failure unresponsive to optimal pharmacotherapy, require heart transplantation. Prognosis in cardiac sarcoidosis is highly variable, dependent on location and severity of heart involvement. This article reviews current diagnostic and therapeutic recommendations for cardiac sarcoidosis. JRCD 2017; 3 (2): 37–43