Cardiac manifestations of sarcoidosis
Dr Frank Gaillard et al.
Cardiac manifestation of sarcoidosis are present in up to 25% of patients with sarcoidosis, but only 5-10% of patients are symptomatic 1-2.
Sarcoidosis is a multisystem disorder characterized by the presence of noncaseating granulomas. For a general discussion of the this condition please refer to: sarcoidosis
Clinical presentation
Over half of patients with autopsy proven cardiac involvement are asymptomatic. Presentations include 1:
- arrhythmias including sudden death (most common)
- heart block
- congestive cardiac failure
- angina pectoris
- ventricular aneurysm formation
Although involvement of the pericardium is rare, constrictive pericarditis has been described 1.
Radiographic features
Although the disease may involve either the left or the right ventricle the left ventricle is involved most commonly.
MRI
Common MRI findings in patients with cardiac sarcoid include:
- delayed enhancement, which may be either mid-wall or transmural
- nodular mid-wall hyperintense foci on black blood T2-weighted imaging
- areas of focal myocardial thickening.
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