Cardiac sarcoidosis

Cardiac sarcoidosis is a specific form of sarcoidosis, a multi-system inflammatory disease, that primarily affects the heart. It is characterized by the formation of granulomas, which are small clumps of immune cells, in the heart tissue. This can lead to various cardiac symptoms and complications, including arrhythmia, heart failure, and sudden cardiac death.

Etiology

The exact cause of cardiac sarcoidosis is unknown. However, it is believed to be an autoimmune response triggered by an unknown substance. Genetic factors may also play a role, as the condition is more common in certain populations, such as those of Scandinavian or African descent.

Pathophysiology

In cardiac sarcoidosis, granulomas form in the heart tissue, leading to inflammation and scarring. This can affect the heart's electrical system, leading to arrhythmias, and can also weaken the heart muscle, leading to heart failure. In severe cases, the disease can cause the heart to stop suddenly, leading to sudden cardiac death.

Clinical Presentation

Symptoms of cardiac sarcoidosis can vary widely, depending on the extent and location of the granulomas. Some people may have no symptoms at all, while others may experience chest pain, shortness of breath, palpitations, lightheadedness, or fainting. In some cases, the first sign of the disease may be sudden cardiac death.

Diagnosis

Diagnosis of cardiac sarcoidosis can be challenging, as the symptoms can be nonspecific and the disease can mimic other heart conditions. A combination of clinical evaluation, imaging studies, and sometimes tissue biopsy may be used to make the diagnosis. The Japanese Ministry of Health and Welfare has established specific criteria for the diagnosis of cardiac sarcoidosis.

Treatment

Treatment of cardiac sarcoidosis is aimed at reducing inflammation and preventing complications. This may involve the use of medications such as corticosteroids, immunosuppressants, and antiarrhythmic drugs. In some cases, devices such as pacemakers or defibrillators may be needed to manage arrhythmias. In severe cases, heart transplantation may be considered.

Prognosis

The prognosis for cardiac sarcoidosis can vary widely, depending on the extent of the disease and the individual's overall health. With appropriate treatment, many people with cardiac sarcoidosis can lead normal lives. However, the disease can be life-threatening in severe cases or if not properly managed.

See Also

• Sarcoidosis
• Heart failure
• Arrhythmia