Cardiac sarcoidosis: improved prognosis through new diagnostic tests and treatment

Cardiac sarcoidosis was diagnosed in 3 patients: 2 men aged 52 and 51 years, respectively, and a woman aged 55 years. Both men had ventricular tachycardia. In the first man, a right-ventricle biopsy revealed a non-caseating granuloma. The second man had active granulomatous cardiac infiltration, acc...

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Bibliographic Details
Published inNederlands tijdschrift voor geneeskunde Vol. 149; no. 21; p. 1168
Main Authors Smedema, J P, van Erven, L, Schreur, J H M, Dijkman-Domanska, B, Snoep, G, Crijns, H J G M
Format Journal Article
LanguageDutch
Published Netherlands 21.05.2005
Subjects
Cardiomyopathies - diagnosis
Cardiomyopathies - therapy
Female
Granuloma - complications
Humans
Male
Middle Aged
Prognosis
Sarcoidosis - diagnosis
Sarcoidosis - therapy
Tachycardia, Ventricular - etiology
Treatment Outcome
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Summary:Cardiac sarcoidosis was diagnosed in 3 patients: 2 men aged 52 and 51 years, respectively, and a woman aged 55 years. Both men had ventricular tachycardia. In the first man, a right-ventricle biopsy revealed a non-caseating granuloma. The second man had active granulomatous cardiac infiltration, according to a gallium scintigram. The first man recovered after receiving immunosuppression, heart-failure medication, and an implantable defibrillator; the second received the same plus radio-frequency catheter ablation, but experienced serious heart failure. The woman was being treated for pulmonary sarcoidosis but complained of progressive cardiac symptoms. She recovered after receiving heart-failure medication, immunosuppression, and a biventricular pacemaker. Sarcoidosis is a multi-system granulomatous disorder of unknown aetiology with cardiac involvement in 20 to 30% of patients, resulting in severe morbidity and mortality. With the help ofgadolinium MRI and positron emission tomography (PET), these conditions can be detected at an earlier stage, which allows for improved evaluation of the efficacy of available therapies. The use of resynchronisation therapy and implantable defibrillators has improved the prognosis of patients with cardiac sarcoidosis.
ISSN:0028-2162