Sarcoidosis is a poorly understood illness in which clumps of abnormal immune cells (granulomas) form, most typically in the lungs, but sometimes in the heart. Cardiac granulomas cause inflammation that can result in the scarring of heart tissue. Genetics are thought to be a significant factor in the development of sarcoidosis.

Cardiac Sarcoidosis Symptoms and Diagnosis

Cardiac sarcoidosis can lead to:

  • Heart muscle dysfunction
  • Congestive heart failure
  • Heart valve problems
  • Arrhythmias that can cause sudden cardiac arrest

Sarcoidosis can affect any part of the heart. While cardiac sarcoidosis is relatively rare, affecting less than 25 percent of all sarcoidosis patients, it is important that known sarcoidosis patients be evaluated for cardiac involvement. Cardiac sarcoidosis is hard to detect and can go undiagnosed until late-stage symptoms develop.

Cardiac sarcoidosis may include symptoms such as:

  • Irregular heartbeat
  • Shortness of breath
  • Coughing
  • Feeling of tightness in the chest
  • Wheezing
  • Chest pain (rare)
  • Leg swelling (may be evident in later stages of the disease)

Sarcoidosis in general can cause a myriad of seemingly unrelated symptoms, including:

  • Shortness of breath
  • Heart palpitations
  • Presyncope (the feeling of lightheadedness and disorientation that can precede fainting)
  • Loss of consciousness
  • Leg swelling
  • Difficulty breathing during the night
  • Unexplained weight gain
  • Recurrent or frequent lung infections
  • Swelling of the lymph nodes
  • Rashes on the face, trunk, arms and legs
  • Dry eye and blurry vision
Risk Factors
  • Race: African Americans are about three to four times more likely to develop sarcoidosis than most other ethnic groups, with an incidence of nearly 2.5 percent.
  • Family history of sarcoidosis: At least five percent of patients have a family member with sarcoidosis.
  • Age of onset varies widely, but is typically between 10 and 45 years old.

A proper diagnosis of cardiac sarcoidosis often depends highly on cardiac imaging, including:

  • Electrocardiogram (ECG or EKG)
  • Echocardiogram
  • Cardiac Positron Emission Tomography (PET)
  • Cardiac Magnetic Resonance Imaging (MRI)
  • Heart biopsy, a surgical procedure to remove and analyze actual heart tissue

Cardiac Sarcoidosis Treatment at BIDMC

Due to the diversity of symptoms, sarcoidosis requires multidisciplinary treatment and care by specialists in, among others:

  • Cardiology
  • Rheumatology
  • Pulmonology
  • Dermatology
  • Ophthalmology
  • Rehabilitation Therapy

Because sarcoidosis can result in significant respiratory complications and cardiac symptoms, surgical interventions in the form of lung and heart transplants may also become necessary.

Treatment often involves immunosuppression — medications that have to be carefully managed to avoid potentially serious complications. Corticosteroids, medications that treat heart injury by reducing inflammation caused by granulomas, are a common treatment.

Some people are not candidates for corticosteroids, such as pregnant women or those who exhibit extreme side effects. These patients may receive other immunosuppression medications to reduce inflammation such as antimalarials.

Learn More

The physicians at the Cardiovascular Institute are world-class experts in treating a range of cardiac conditions. We have the most advanced tools to diagnose and treat as well as provide guidance to prevent and manage heart disease.

We are renowned for our clinical care which puts patients at the center of everything we do.
 

Cardiovascular Institute