Document Detail

Sarcoid heart disease.
MedLine Citation:
PMID:  14968147     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Sarcoidosis is a multisystem inflammatory disease of unknown cause. Due to its protean and nonspecific clinical manifestations, the optimal diagnostic and therapeutic strategies, as well as prognosis, are not well defined. OBJECTIVE: To review the literature on sarcoid heart disease and present an approach to its diagnosis, prognosis and therapy. METHODS: MEDLINE and PreMEDLINE searches of all available English-language articles and case reports from 1966 to 2002 were performed. Search terms included 'sarcoidosis' and 'heart diseases', with a variety of medical subject subheadings. RESULTS: Clinical disease often includes heart block, dilated cardiomyopathy and ventricular arrhythmias. Patients with sarcoidosis are at increased risk of sudden death. Because the yield of endomyocardial biopsy for definitive diagnosis is low, the diagnosis is often made with a combination of electrocardiography, Holter monitoring, echocardiography, myocardial perfusion imaging and, most recently, magnetic resonance imaging. For symptomatic patients, medical therapy may include a trial of steroids and immunosuppressive therapy. Monoclonal antibodies against tumour necrosis factor may be employed in refractory cases. Heart block warrants a permanent pacemaker, while ventricular tachyarrhythmias are typically amiodarone-unresponsive, requiring implantation of an implantable cardioverter defibrillator. CONCLUSIONS: Although there are no large, randomized trial data on cardiac sarcoidosis, the literature suggests that making the diagnosis is clinically important. Unlike the situation in isolated pulmonary disease, cardiac involvement implies a poor prognosis. The diagnosis often requires high clinical suspicion with a combination of radiological and nuclear imaging. Therapy with steroids may halt progression of left ventricular dysfunction, while arrhythmias warrant device therapy.
Jaffer Syed; Robert Myers
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  20     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-02-17     Completed Date:  2004-03-03     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  89-93     Citation Subset:  IM    
Internal Medicine and Cardiology, University of Toronto, Toronto, Ontario, Canada.
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MeSH Terms
Adrenal Cortex Hormones / therapeutic use
Age Distribution
Biopsy, Needle
Cardiomyopathies / epidemiology,  pathology*,  therapy*
Death, Sudden, Cardiac*
Middle Aged
Ontario / epidemiology
Pacemaker, Artificial
Risk Assessment
Sarcoidosis / epidemiology,  pathology*,  therapy*
Severity of Illness Index
Sex Distribution
Survival Analysis
Reg. No./Substance:
0/Adrenal Cortex Hormones

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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