| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Circulation, Vol 58, 1204-1211, Copyright © 1978 by American Heart Association
KJ Silverman, GM Hutchins and BH Bulkley
Although sarcoid may involve the myocardium, there is little information on
its incidence or significance. We studied 84 consecutive autopsied patients
with sarcoidosis. The patients ranged in age from 18- -80 years (average 46
years) and 61% were women; 23 (27%) of them had myocardial granulomas. In
eight (35%) these were clinically silent, and in 15 (65%) there was a
history of heart failure and/or arrhythmias and conduction defects. Of the
23 patients, only four (17%) had grossly evident, widespread myocardial
lesions: three of these four (75%) had documented arrhythmias. All four had
sudden, unexpected death at an average age of 36 years; in only two had
sarcoid been suspected during life. The other 19 patients (83%) had
microscopically evident granulomatous involvement. Of these, eight (42%)
had a thythm or conduction disturbance and three (16%) sudden death,
although none of those who suffered sudden death had a recognized rhythm or
conduction disturbance. Nine (15%) of those without cardiac sarcoidosis had
a rhythm or conduction disturbance and eight (13%) suffered a sudden death.
The results show that although myocardial involvement occurs in at least
25% of patients with sarcoid, it most often involves a small portion of
myocardium and is clinically silent. Since some of the 61 patients in whom
myocardial lesions were not identified may still have had small microscopic
granulomas, the true incidence of myocardial sarcoid may be even greater
than suggested here. Rhythm and conduction disturbances are more common in
the cardiac sarcoid group, but the findings suggest that only the small
subset of patients with severe, grossly evident myocardial sarcoid are at
increased risk for sudden death.
ARTICLES
Cardiac sarcoid: a clinicopathologic study of 84 unselected patients with systemic sarcoidosis
This article has been cited by other articles:
 |
|
 |
|
  D. Mehta, S. A. Lubitz, Z. Frankel, J. P. Wisnivesky, A. J. Einstein, M. Goldman, J. Machac, and A. Teirstein Cardiac Involvement in Patients with Sarcoidosis: Diagnostic and Prognostic Value of Outpatient Testing Chest, June 1, 2008; 133(6): 1426 - 1435. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Uusimaa, K. Ylitalo, O. Anttonen, T. Kerola, V. Virtanen, E. Paakko, and P. Raatikainen Ventricular tachyarrhythmia as a primary presentation of sarcoidosis Europace, June 1, 2008; 10(6): 760 - 766. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. Glower and J. E. Lowe Left Ventricular Aneurysm Card. Surg. Adult, January 1, 2008; 3(2008): 803 - 822. [Full Text]
|
|
|
|
 |
|
 L. T. Cooper, K. L. Baughman, A. M. Feldman, A. Frustaci, M. Jessup, U. Kuhl, G. N. Levine, J. Narula, R. C. Starling, J. Towbin, et al. The role of endomyocardial biopsy in the management of cardiovascular disease: A Scientific Statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology Eur. Heart J., December 2, 2007; 28(24): 3076 - 3093. [Full Text] [PDF]
|
|
|
|
 |
|
 M. W. Hansen and N. Merchant MRI of Hypertrophic Cardiomyopathy: Part 2, Differential Diagnosis, Risk Stratification, and Posttreatment MRI Appearances Am. J. Roentgenol., December 1, 2007; 189(6): 1344 - 1352. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. T. Cooper, K. L. Baughman, A. M. Feldman, A. Frustaci, M. Jessup, U. Kuhl, G. N. Levine, J. Narula, R. C. Starling, J. Towbin, et al. The Role of Endomyocardial Biopsy in the Management of Cardiovascular Disease: A Scientific Statement From the American Heart Association, the American College of Cardiology, and the European Society of Cardiology Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology J. Am. Coll. Cardiol., November 6, 2007; 50(19): 1914 - 1931. [Full Text] [PDF]
|
|
|
|
 |
|
 L. T. Cooper, K. L. Baughman, A. M. Feldman, A. Frustaci, M. Jessup, U. Kuhl, G. N. Levine, J. Narula, R. C. Starling, J. Towbin, et al. The Role of Endomyocardial Biopsy in the Management of Cardiovascular Disease: A Scientific Statement From the American Heart Association, the American College of Cardiology, and the European Society of Cardiology Circulation, November 6, 2007; 116(19): 2216 - 2233. [Full Text] [PDF]
|
|
|
|
 |
|
 A. R Doughan and B. R Williams Cardiac sarcoidosis Heart, February 1, 2006; 92(2): 282 - 288. [Full Text] [PDF]
|
|
|
|
|
|
S. Ishimaru, I. Tsujino, T. Takei, E. Tsukamoto, S. Sakaue, M. Kamigaki, N. Ito, H. Ohira, D. Ikeda, N. Tamaki, et al. Focal uptake on 18F-fluoro-2-deoxyglucose positron emission tomography images indicates cardiac involvement of sarcoidosis Eur. Heart J., August 1, 2005; 26(15): 1538 - 1543. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Judson Cardiac Sarcoidosis: There Is No Instant Replay Chest, July 1, 2005; 128(1): 3 - 6. [Full Text] [PDF]
|
|
|
|
|
|
E. Tadamura, M. Yamamuro, S. Kubo, S. Kanao, T. Saga, M. Harada, M. Ohba, R. Hosokawa, T. Kimura, T. Kita, et al. Effectiveness of Delayed Enhanced MRI for Identification of Cardiac Sarcoidosis: Comparison with Radionuclide Imaging Am. J. Roentgenol., July 1, 2005; 185(1): 110 - 115. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Okumura, T. Iwasaki, T. Toyama, T. Iso, M. Arai, N. Oriuchi, K. Endo, T. Yokoyama, T. Suzuki, and M. Kurabayashi Usefulness of Fasting 18F-FDG PET in Identification of Cardiac Sarcoidosis J. Nucl. Med., December 1, 2004; 45(12): 1989 - 1998. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Chevalet, R. Clement, O. Rodat, A. Moreau, J.-M. Brisseau, and J.-P. Clarke Sarcoidosis Diagnosed in Elderly Subjects: Retrospective Study of 30 Cases Chest, November 1, 2004; 126(5): 1423 - 1430. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E Hyodo, T Hozumi, Y Takemoto, H Watanabe, T Muro, H Yamagishi, M Yoshiyama, K Takeuchi, and J Yoshikawa Early detection of cardiac involvement in patients with sarcoidosis by a non-invasive method with ultrasonic tissue characterisation Heart, November 1, 2004; 90(11): 1275 - 1280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Nakazawa, K. Ikeda, Y. Ito, M. Iwase, K. Sato, R. Ueda, and Y. Dohi Usefulness of Dual 67Ga and 99mTc-Sestamibi Single-Photon-Emission CT Scanning in the Diagnosis of Cardiac Sarcoidosis Chest, October 1, 2004; 126(4): 1372 - 1376. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Yamagishi, N. Shirai, M. Takagi, M. Yoshiyama, K. Akioka, K. Takeuchi, and J. Yoshikawa Identification of Cardiac Sarcoidosis with 13N-NH3/18F-FDG PET J. Nucl. Med., July 1, 2003; 44(7): 1030 - 1036. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Heath, H Deubner, E J Stern, J E Cooke, and E A Gill A 28 year old woman with ventricular tachycardia and an abnormal chest radiograph Heart, June 1, 2003; 89(6): e19 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. P. Sharma Diagnosis of Cardiac Sarcoidosis: An Imperfect Science, A Hesitant Art Chest, January 1, 2003; 123(1): 18 - 19. [Full Text] [PDF]
|
|
|
|
|
|
D. D. Glower and J. E. Lowe Left Ventricular Aneurysm Card. Surg. Adult, January 1, 2003; 2(2003): 771 - 788. [Full Text]
|
|
|
|
|
|
O. Vignaux, R. Dhote, D. Duboc, P. Blanche, D. Dusser, S. Weber, and P. Legmann Clinical Significance of Myocardial Magnetic Resonance Abnormalities in Patients With Sarcoidosis: A 1-Year Follow-up Study Chest, December 1, 2002; 122(6): 1895 - 1901. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Medinger, S. Khouri, and P. K. Rohatgi Sarcoidosis : The Value of Exercise Testing Chest, July 1, 2001; 120(1): 93 - 101. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. G. Ford, J. L. Jorizzo, and M. G. Hitchcock Previously Undiagnosed Sarcoidosis in a Patient Presenting With Leonine Facies and Complete Heart Block Arch Dermatol, June 1, 2000; 136(6): 712 - 714. [Full Text] [PDF]
|
|
|
|
|
|
M J Davies CARDIOMYOPATHY: The cardiomyopathies: an overview Heart, April 1, 2000; 83(4): 469 - 474. [Full Text]
|
|
|
|
 |
|
 H. M. Greenberg and H. T. Aretz Case 31-1999- A 33-Year-Old Man with Wide-Complex Tachycardia and a Left Ventricular Mass N. Engl. J. Med., October 14, 1999; 341(16): 1217 - 1224. [Full Text] [PDF]
|
|
|
|
 |
|
 A. K. Shetty and A. Gedalia Sarcoidosis: A Pediatric Perspective Clinical Pediatrics, December 1, 1998; 37(12): 707 - 717. [Abstract] [PDF]
|
|
|
|
|
|
B. A. McGovern and D. B. Flieder Case 34-1996- A 50-Year-Old Woman with Cardiac Disease, an Electronic Pacemaker, and Cardiac Arrest in Ventricular Fibrillation N. Engl. J. Med., October 31, 1996; 335(18): 1378 - 1386. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Y. H. Lip, J. Gupta, J. S. Gill, and S. P. Singh Sarcoid Heart Disease: A Rare Cause of Chest Pain and Malignant Cardiac Arrhythmia in a Young Asian Man: A Case Report Angiology, September 1, 1996; 47(9): 905 - 910. [Abstract] [PDF]
|
|
|
|
|
|
F.J. Venditti and E.J. Mark Case 16-1995- A 35-year-old man with dilated cardiomyopathy, repeated ventricular tachycardia, and pulmonary lesions N. Engl. J. Med., May 25, 1995; 332(21): 1432 - 1438. [Full Text] [PDF]
|
|
|
|
|
|
F. J. Venditti and J. T. Fallon Case 47-1993- A 28-Year-Old Man with Recurrent Ventricular Tachycardia and Dysfunction of Multiple Organs N. Engl. J. Med., November 25, 1993; 329(22): 1639 - 1647. [Full Text]
|
|
|
|
|
|
B. R. Celli and E. J. Mark Case 11-1993- A 52-Year-Old Man with Cardiomyopathy and Pulmonary Disease N. Engl. J. Med., March 18, 1993; 328(11): 792 - 800. [Full Text]
|
|