[Cardiac sarcoidosis: diagnostics, treatment and follow-up]

Pol Merkur Lekarski. 2018 Mar 27;44(261):124-129.
[Article in Polish]

Abstract

Sarcoidosis is a generalised granulomatous disorder of unknown aetiology. Cardiac involvement may affect conduction system, myocardium, valvular apparatus and pericardium. Clinical spectrum ranges from asymptomatic involvement to sudden cardiac death. Patients with biopsy-proven extracardiac sarcoidosis should be screened for cardiac involvement (standard ECG, 24-hour Holter ECG, echocardiography) and in case of any abnormalities found on these tests, more advanced diagnostic methods should be used. Steroid treatment is still the mainstay of therapy in cardiac sarcoidosis. Several immunosuppresive agents are also effective and used in different combinations with steroids, as well as heart failure treatment (including ACE inhibitors, angiotensin receptor blockers, beta-blockers and diuretics). Advanced heart block requires pacemaker implantation, and implantable cardioverterdefibrillator is an effective treatment in primary and secondary prophylaxis of sudden cardiac death. Heart transplantation is considered in advanced, drug-resistant heart failure or incessant ventricular arrhythmias unresponsive to other forms of therapy.

Keywords: cardiac sarcoidosis; glicocorticosteroid treatment; pharmacotherapy; sarcoidosis.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Angiotensin Receptor Antagonists / therapeutic use
  • Arrhythmias, Cardiac / etiology
  • Arrhythmias, Cardiac / therapy
  • Cardiomyopathies / complications
  • Cardiomyopathies / diagnosis*
  • Cardiomyopathies / drug therapy
  • Cardiomyopathies / immunology
  • Cholinesterase Inhibitors / therapeutic use
  • Electrocardiography, Ambulatory
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Magnetic Resonance Imaging
  • Monitoring, Physiologic
  • Positron-Emission Tomography
  • Practice Guidelines as Topic
  • Sarcoidosis / complications
  • Sarcoidosis / diagnosis*
  • Sarcoidosis / drug therapy
  • Sarcoidosis / immunology

Substances

  • Adrenal Cortex Hormones
  • Angiotensin Receptor Antagonists
  • Cholinesterase Inhibitors
  • Immunosuppressive Agents