[Myocardial sarcoidosis--new dignostic and therapeutic procedures]

Sarcoidosis is a multisystem granulomatous disorder of unknown etiology. Clinical manifestations depend on the disease activity and organ involvement. The actual incidence of myocardial sarcoidosis has never been established. Manifestations range from accidental findings and benign conditions to fatal cardiomyopathies and arrhythmias.

Bernstein et al. first described myocardial sarcoidosis in 1929, and Getzen first described a lethal case caused by myocardial sarcoidosis in 1937. A definite histological diagnosis of sarcoidosis is dificult to make, and in some cases treatment should be initiated without histological confirmation. An optimal strategy for establishing diagnosis of myocardial sarcoidosis is not clear. Thallium scintigraphy (with additional use of gallium and technetium) is most often used and investigated 2D echocardiography is less sensitive, but could be an additional tool in diagnostics. New non-invasive techniques, such as magnetic resonance imaging (MRI) and positron emission tomography (PET) can also be applied in diagnostics of this disease. Considering life-threatening potential of myocardial sarcoidosis, prompt and aggressive treatment with corticosteroids and/or inmmunosuppressive drugs is necessary.

Recognition of myocardial sarcoidosis and choice of adequate treatment regimen requires maximal involvement and team work of cardiologists and respirator), specialists. This paper also deals with new diagnostic and therapeutic procedures, because early diagnosis and initiation of adequate treatment are the main prognostic factors of myocardial sarcoidosis.