Cardiac sarcoidosis: a review 2011

Cardiac involvement in sarcoidosis is not always associated with a wide spread of disease, but when present, has been linked with a relatively poor prognosis. This review will delve into new genetic associations, recently reported clinical manifestations and complementary radiographic tools that aid with diagnosis and follow-up.

Clinical manifestations, diagnosis and management remain an intricate maze.Genetic predisposition and associations that include HLA class II molecules and polymorphisms in tumor necrosis factor-α have been reported due in part to weakened arguments suggesting autoimmune disorders or dysregulation. In addition, further symptomatologies have been reported that assist with diagnosis.Radiographic tools including Microvolt T wave alternans, cardiovascular magnetic resonance, late gadolinium enhancement and cardiac assist devices, recently being used, are shedding some light on the diagnostic challenges.

Cardiac involvement in sarcoidosis remains a challenging dilemma, relying on a combination of clinical findings and imaging abnormalities because no single diagnostic test has yet emerged with a high degree of specificity and sensitivity. Given its life-threatening nature, prompt establishment of a diagnosis, an aggressive management strategy and devices to prolong life should be pursued.