title: Cardiac sarcoidosis: diagnosis and management.
abstract: Cardiac sarcoidosis is one of the most serious and unpredictable aspects of this disease state. Heart involvement frequently presents with arrhythmias or conduction disease, although myocardial infiltration resulting in congestive heart failure may also occur. The prognosis in cardiac sarcoidosis is highly variable, which relates to the heterogeneous nature of heart involvement and marked differences between racial groups. Electrocardiography and echocardiography often provide the first clue to the diagnosis, but advanced imaging studies using positron emission tomography and MRI, in combination with nuclear isotope perfusion scanning are now essential to the diagnosis and management of this condition. The identification of clinically occult cardiac sarcoidosis and the management of isolated and/or asymptomatic heart involvement remain both challenging and contentious. Corticosteroids remain the first treatment choice with the later substitution of immunosuppressive and steroid-sparing therapies. Heart transplantation is an unusual outcome, but when performed, the results are comparable or better than heart transplantation for other disease states. We review the epidemiology, developments in diagnostic techniques and the management of cardiac sarcoidosis.
authors.affiliation: Department of Cardiology, Hillingdon Hospital, Uxbridge, UK.
authors.forename: S W
authors.initials: SW
authors.lastname: Dubrey
authors.affiliation: Department of Cardiology, The Royal Brompton Hospital, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of Radiology, Harefield Hospital, Harefield, UK.
authors.forename: R
authors.initials: R
authors.lastname: Underwood
authors.affiliation: Department of Radiology, Harefield Hospital, Harefield, UK.
authors.forename: T
authors.initials: T
authors.lastname: Mittal
mesh_terms: D002118:Calcium / Q000097:blood; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D004562:Electrocardiography / Q000639:trends; D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000639:trends; D006801:Humans; D033162:Incidental Findings; D007564:Japan / Q000453:epidemiology; D008279:Magnetic Resonance Imaging / Q000639:trends; D008297:Male; D049268:Positron-Emission Tomography / Q000639:trends; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012507:Sarcoidosis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D014057:Tomography, X-Ray Computed / Q000639:trends; D014807:Vitamin D / Q000097:blood
chemical_list: D014807:Vitamin D; D002118:Calcium