Sarcoidosis of the cardiac conducting system

In a consecutive series of 2.950 routine autopsies two of 13 cases with sarcoidosis had cardiac involvement, one of which showed extensive granulomatous lesions in the sinus node. It is suggested that sudden death in this 52-year-old woman was caused by cardiac sarcoid involvement, possibly by leading to sinus arrest with cardiac standstill. However, because of the lack of electrocardiographic evidence, sudden death from ventricular fibrillation can not be excluded. As sudden death is a well-known complication in sarcoidosis, all such patients should be regularly screened for cardiac involvement in order to prevent fatal arrhythmias.