Anginal chest pain in sarcoidosis.

Area of Science:

• Cardiology
• Pulmonology
• Immunology

Background:

• Sarcoidosis is a multisystem inflammatory disease.
• Cardiac involvement in sarcoidosis can lead to various cardiovascular symptoms.
• Angina pectoris is a recognized but less commonly reported symptom in sarcoidosis patients.

Purpose of the Study:

• To investigate the prevalence and characteristics of anginal chest pain in Black male patients with sarcoidosis.
• To assess the association between chest pain, myocardial perfusion abnormalities, and coronary artery disease in this population.
• To explore the potential role of cardiac sarcoidosis in the etiology of anginal chest pain.

Main Methods:

• Prospective study of 43 Black patients with sarcoidosis, focusing on 12 reporting chest pain.
• Cardiopulmonary assessment including exercise and redistribution thallium-201 scans.
• Coronary angiography performed in selected patients.
• Comparison with 9 age- and disease-duration-matched sarcoidosis patients without chest pain.

Main Results:

• 12 of 43 (28%) patients experienced chest pain meeting angina criteria.
• 6 of these 12 patients showed thallium scan evidence of myocardial ischemia.
• All patients with ischemia had normal coronary angiograms; control patients had no ischemia.
• 10 of 12 patients with chest pain had abnormal thallium scans (ischemia or non-specific).
• Nitrates provided symptom relief in most patients with anginal chest pain.

Conclusions:

• Anginal chest pain is a frequent manifestation in Black male patients with sarcoidosis.
• Abnormal myocardial perfusion scans in these patients, despite normal coronary arteries, suggest cardiac involvement.
• Myocardial sarcoidosis is a likely cause of anginal chest pain in this demographic.