EUH Dressler Conference: A review of cardiac sarcoidosis

The Bottom Line: Cardiac sarcoidosis (CS) is the cardiac manifestations of sarcoidosis, a systemic disease of unknown cause characterized by immune granulomas. Cardiac involvement is clinically apparent in 5% of patients with sarcoidosis, but detected in approximately 20% of white and black American persons and 70-80% of Japanese persons at autopsy. The classification of CS is based on disease course:

  • acute sarcoidosis (Lofgren syndrome) resolves spontaneously within 2 years
  • chronic sarcoidosis resolves within ≥ 3-5 years
  • refractory sarcoidosis characterized by progressive disease despite treatment

(DynaMed Plus, 2017)

References: Yatsynovich Y, Dittoe N, Petrov M, Maroz N. Cardiac sarcoidosis: A review of contemporary challenges in diagnosis and treatment. Am J Med Sci. 2018 Feb;355(2):113-125. Doi:10/1016/j.amjms.2017.08.009

DynaMed Plus [Internet]. Ipswich (MA): EBSCO Information Services. 1995 – . Record No. 306338, Cardiac sarcoidosis; [updated 2017 Mar 31, cited 2018 Apr 13]; [about 11 screens]. Available from Emory login required.

Summary: CS may be asymptomatic and is often presented by sudden death. Most deaths attributed to CS are caused by arrhythmias or conduction system disease, and congestive heart failure may occur. Current consensus on diagnosis relies on endomyocardial biopsy, in the absence of which, histologic proof of extracardiac sarcoid involvement is necessitated. The primary therapeutic approaches are broadly divided into two categories: pharmacological management and invasive or device oriented (Yatsynovich, Dittoe, Petrov, & Maroz, 2018).