Sarcoid heart disease

Myocardial sarcoidosis is not a rare disease in the UK and it is still probably under-diagnosed. A high index of suspicion in necessary for diagnosis of myocardial sarcoidosis, which should be thought of in any unusual form of heart disease for which there is no adequate explanation, particularly if there are serious rhythm changes or unexplained heart failure. Mitral systolic murmurs occur frequently. Histological proof of the aetiology should be sought. The heart is frequently massively involved when other organs have little involvement. Most of these patients present with cardiac symptoms or signs and the high incidence of sudden death is disturbing. The high rate of occurrence in East Anglia is noted, and merits further study. Treatment should be energetic where indicated--but its effects are difficult to assess. This study, representing the largest single source of information on this topic, continues in the hope of shedding more light on a sinister disease.