Cardiac sarcoidosis: the Christchurch experience

Adamson, Paula; Melton, I.; O’Donnell, John J.; Macdonald, S.; Crozier, Ian

doi:10.1111/imj.12314

Cited by 18 publications

(9 citation statements)

References 30 publications

(44 reference statements)

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“…The time interval from initial negative assessment to the development of evidence of ECS was not reported. 15 Table 2 summarizes the current evidence regarding the diagnosis of ICS.…”

Section: Introductionmentioning

confidence: 99%

Isolated cardiac sarcoidosis: A focused review of an under-recognized entity

Okada

Bravo

Vita

et al. 2018

Journal of Nuclear Cardiology

132

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There is accumulating evidence for the existence of a phenotype of isolated cardiac sarcoidosis (ICS), or sarcoidosis that only involves the heart. In the absence of biopsy-confirmed cardiac sarcoidosis (CS), existing diagnostic criteria require the presence of extra-cardiac sarcoidosis as an inclusion criterion for the diagnosis of CS. Consequently, in the absence of a positive endomyocardial biopsy, ICS is not diagnosable by current guidelines. Therefore, there is uncertainty regarding the epidemiology, pathobiology, clinical characteristics, prognosis, and optimal treatment of ICS. This review will summarize the available data related to the prevalence and prognosis of ICS and will discuss challenges surrounding the diagnosis and management of this under-recognized entity.

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“…The time interval from initial negative assessment to the development of evidence of ECS was not reported. 15 Table 2 summarizes the current evidence regarding the diagnosis of ICS.…”

Section: Introductionmentioning

confidence: 99%

Isolated cardiac sarcoidosis: A focused review of an under-recognized entity

Okada

Bravo

Vita

et al. 2018

Journal of Nuclear Cardiology

132

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“…Serum ACE (SACE) is frequently elevated during active disease, but is non-specific, being elevated in other granulomatous diseases. Although SACE levels are unreliable diagnostically,45 46 levels are sometimes used to follow treatment responses 47. An excess of immunoglobulin (hypergammaglobulinaemia) may occur due to a recognised B-cell ‘proliferation’,48 and routine bloods may indicate elevated inflammatory markers.…”

Section: Diagnostic Testsmentioning

confidence: 99%

Cardiac sarcoidosis: diagnosis and management

Dubrey

Sharma

Underwood

et al. 2015

Postgraduate Medical Journal

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Cardiac sarcoidosis is one of the most serious and unpredictable aspects of this disease state. Heart involvement frequently presents with arrhythmias or conduction disease, although myocardial infiltration resulting in congestive heart failure may also occur. The prognosis in cardiac sarcoidosis is highly variable, which relates to the heterogeneous nature of heart involvement and marked differences between racial groups. Electrocardiography and echocardiography often provide the first clue to the diagnosis, but advanced imaging studies using positron emission tomography and MRI, in combination with nuclear isotope perfusion scanning are now essential to the diagnosis and management of this condition. The identification of clinically occult cardiac sarcoidosis and the management of isolated and/or asymptomatic heart involvement remain both challenging and contentious. Corticosteroids remain the first treatment choice with the later substitution of immunosuppressive and steroid-sparing therapies. Heart transplantation is an unusual outcome, but when performed, the results are comparable or better than heart transplantation for other disease states. We review the epidemiology, developments in diagnostic techniques and the management of cardiac sarcoidosis.

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“…[ 36 37 ] CS was detected in 39% of our patients with symptoms, indicating that if any symptoms are present, they should not be ignored. [ 10 21 23 29 38 39 ] Unfortunately, the absence of cardiac-related symptoms, despite preserved left ventricular systolic function, does not exclude the diagnosis of CS. [24] …”

Section: Discussionmentioning

confidence: 99%