Sarcoid heart disease

Sarcoid heart disease has had slow recognition but it is now being increasingly diagnosed in life and at necropsy. Recognition is important as energetic treatment may greatly improve the prognosis. Although patients with 'classical' sarcoidosis may be found to have cardiac involvement, most of the clinically important cases present with cardiac problems--sudden death, heart block, tachyarrhythmias and 'cardiomyopathy'--are the most frequent presentations. Sarcoidosis should be thought of in any case of difficult heart disease for which there is no obvious aetiology. Histological confirmation of sarcoidosis in some organ should be sought. Energetic treatment and follow up show that the prognosis is not necessarily bad.