Joint Committee on Aviation Pathology: XIII. Sarcoid and the heart--an aeromedical risk

Sarcoid lesions of the heart are reported in 13% to 20% of sarcoidosis patients. Sudden death and ventricular arrhythmias occur in 40% to 50%. In view of this frequency and life-threatening significance, review of military aircrew with documented sarcoidosis for myocardial involvement was undertaken. Case records were available for 11 US Army, 19 US Air Force, and 6 US Navy patients. Four patients (11%) had significant cardiac abnormalities to include sustained ventricular arrhythmias, and acquired anteroseptal infarction pattern by ECG with nomal coronary angiography. ECG abnormalities were found in eight additional patients. Suspected involvement of the heart in 33% of this series warrants complete cardiovascular evaluation of the sarcoid patient prior to return to flying duties. A case report demonstrates the difficulty in evaluating ECG abnormalities in the antemortem diagnosis of sarcoid heart disease.