Cardiac sarcoidosis: a diagnostic and therapeutic challenge

Acta Cardiol. 2018 Feb;73(1):1-6. doi: 10.1080/00015385.2017.1325633. Epub 2017 Jul 4.

Abstract

Objective: Cardiac involvement in sarcoidosis can present in various ways, with atrioventricular (AV) block and ventricular arrhythmias being the most common signs. Because of initial non-specific findings, diagnosis can be a challenge. Very few data can support treatment decisions as cardiac manifestations of this systemic disorder are rare.

Methods and results: We reviewed current guidelines, cohort studies, and expert opinions concerning diagnosis and treatment of cardiac sarcoidosis.

Conclusions: Longitudinal follow-up studies are necessary to improve the diagnostic process and risk stratification of cardiac sarcoidosis. The optimal dose of steroids, indications for internal cardioverter-defibrillator (ICD), and technique and optimal timing of ablation are still under debate.

Keywords: Sarcoidosis; ablation; arrhythmias; devices; imaging; immunosuppressants.

Publication types

  • Review

MeSH terms

  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / etiology
  • Arrhythmias, Cardiac / therapy
  • Cardiomyopathies* / complications
  • Cardiomyopathies* / diagnosis
  • Cardiomyopathies* / therapy
  • Catheter Ablation / methods*
  • Diagnostic Techniques, Cardiovascular*
  • Electric Countershock / methods*
  • Humans
  • Immunosuppression Therapy / methods*
  • Sarcoidosis* / complications
  • Sarcoidosis* / diagnosis
  • Sarcoidosis* / therapy