Cardiac Sarcoidosis - 20/11/15

Doi : 10.1016/j.ccm.2015.08.008

David Birnie, MD, MB ChB ^a,^⁎ , Andrew C.T. Ha, MD ^b, Lorne J. Gula, MD, MSc ^c, Santabhanu Chakrabarti, MBBS, MD ^d, Rob S.B. Beanlands, MD ^a, Pablo Nery, MD ^a
^a Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4 W7, Canada
^b Department of Medicine, Peter Munk Cardiac Centre, University Health Network, University of Toronto, GW 3-558A, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
^c Division of Cardiology, London Health Sciences Centre, 339 Windermere Road, c6-110, London, Ontario N6A 5A5, Canada
^d Division of Cardiology, Department of Medicine, University of British Columbia, 211 1033, Davie Street, Vancouver, British Columbia V6E 1M7, Canada

^∗Corresponding author.

Résumé

Studies suggest clinically manifest cardiac involvement occurs in 5% of patients with pulmonary/systemic sarcoidosis. The principal manifestations of cardiac sarcoidosis (CS) are conduction abnormalities, ventricular arrhythmias, and heart failure. Data indicate that an 20% to 25% of patients with pulmonary/systemic sarcoidosis have asymptomatic (clinically silent) cardiac involvement. An international guideline for the diagnosis and management of CS recommends that patients be screened for cardiac involvement. Most studies suggest a benign prognosis for patients with clinically silent CS. Immunosuppression therapy is advocated for clinically manifest CS. Device therapy, with implantable cardioverter defibrillators, is recommended for some patients.

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Keywords : Cardiac sarcoidosis, Clinically silent, Clinically manifest, Atrioventricular block, Ventricular arrhythmias, Heart failure, Sudden cardiac death