When the body encounters a foreign substance that it cannot destroy, the immune system sends special cells to surround the substance, building a wall around it that prevents it from interacting with the rest of the body. The resulting bundle of cells, which typically resembles a tumor, is called a granuloma. When the bundles of cells clump together in a particular organ, it causes a condition called sarcoidosis. Sometimes, those cells clump together in or around the heart, and this condition is referred to as cardiac sarcoidosis.
Sarcoidosis in general is fairly rare, and cardiac sarcoidosis occurs in about 25 percent of all cases. The condition has the potential to become fatal very quickly, with some cases resulting in sudden death before other symptoms are even present. Anyone can be affected by the disease, although it tends to favor women in their 20s and 30s. Scientists are still trying to determine the exact cause of sarcoidosis, but they believe that some people may be genetically predisposed to the disease.
The symptoms associated with cardiac sarcoidosis vary depending on the severity of the condition and the complications that it causes. Some patients feel no symptoms at all, while others may experience heart palpitations, difficulty breathing, and swelling in the legs. Chest pain can also occur, especially when cardiac sarcoidosis leads to pericarditis, or inflammation around the heart.
Doctors use various tools, including magnetic resonance imaging (MRI) or echocardiograms, to diagnose cardiac sarcoidosis. If those diagnostic tools are not sufficient and test results remain inconclusive, a cardiac biopsy may be performed. During this procedure, a tissue sample of the affected area is collected through use of a catheter inserted into an artery or vein, and is guided to the heart using an x-ray image.
Treatment of cardiac sarcoidosis depends on the patient’s tolerance to certain medications and the symptoms that the condition is causing. Although there is no set treatment regimen for the condition, doctors typically turn towards corticosteroids as their first choice because they have a good success record in treating cardiac inflammation. If that isn’t feasible, other immunosuppressants may be used. Treatments and medications are also prescribed to relieve the heart-related conditions caused by cardiac sarcoidosis.
Patients with other forms of sarcoidosis are especially susceptible to developing cardiac sarcoidosis, and routine heart monitoring tests should be part of a treatment regimen. Those with a family history of sarcoidosis should also be screened at regular intervals. Sarcoidosis can resolve on its own without medical intervention in some cases, but when it affects the heart, early detection is important.
