[Cardiac sarcoidosis verified histologically by endovenous myocardial biopsy]

The female patient with sarcoidosis simultaneously involving the lungs, heart, liver, eyes, skin and lacrimal glands is presented. The diagnosis of this disorder was established by biopsy of the liver and skin as well as by at our institution newly introduced method of endovenous blind-myocardial biopsy. Generalized active sarcoidosis had brought the patient into a very profound cachectic state (body weight 48 kg), but her life was directly endangered by granulomatous inflammation of the myocardium with the development of cardiac decompensation, grade I and II atrioventricular conduction disturbances as well as by transitory and total AV block with frequent arrhythmias. A significant resolution of the disease occurred after the introduction of corticosteroid therapy. However, grade I AV block persisted even after one year of treatment, suggesting that the syndrome has probably proceeded from granulomatous inflammation to fibrosis. Therefore, the patient is still a potential candidate for an electrostimulator.