cardiac sarcoidosis
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Epidemiology
- 25% of cardiac sarcoidosis are isolated to the heart
Clinical manifestations
- dilated cardiomyopathy, LV systolic dysfunction (HFrEF)
- Mobitz type-2 second degree AV block or third degree heart block
- sustained monomorphic ventricular tachycardia
Diagnostic procedures
- endomyocardial biopsy
- most specfid test, but sensitivity is low
Radiology
- cardiac magnetic resonance imaging (CMRi)
- dilated cardiomyopathy[1]
- suspected restrictive cardiomyopathy[1]
- delayed gadolinium hyperenhancement generally of the mid myocardial wall or epicardium
- findings indicative of inflammation in distribution atypical for coronary artery disease[1]
- also useful for excluding constrictive pericarditis
- 18F-fluorodeoxyglucose (FDG) PET scan if CMRi is negative
Management
- treat LV systolic dysfunction (HFrEF)
- cardiac rhythm reassessment prior to starting antiarrhythmic therapy
- if active inflammation, immunosuppressive therapy may improve arrhythmias
- glucocorticoids are first-line treatment[2]
More general terms
References
- ↑ 1.0 1.1 1.2 1.3 Markatis E, Afthinos A, Antonakis E et al. Cardiac sarcoidosis: diagnosis and management. Rev Cardiovasc Med. 2020;21:321-38. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33070538
- ↑ 2.0 2.1 Cheng RK, Kittleson MM, Beavers CJ et al; American Heart Association Heart Failure and Transplantation Committee of the Council on Clinical Cardiology, and Council on Cardiovascular and Stroke Nursing Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association. Circulation. 2024 Apr 18. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38634276 Review.