The Japanese Ministry of Health and Welfare issued criteria for the diagnosis of cardiac sarcoidosis in 1993. This can help identify patients with myocardial involvement who may benefit from steroid therapy.


Diagnostic groups:

(1) confirmed by histology

(2) suspected based on clinical findings


Histologic diagnosis: Epithelioid granulomas without caseating granulomas identified on histologic examination of an operative or endomyocardial biopsy specimen.


Clinical diagnosis: all of the following:

(1) histologic diagnosis of extracardiac sarcoidosis

(2) electrocardiogram showing one or more of the following:

(2a) complete right bundle branch block (RBBB)

(2b) left-axis deviation

(2c) atrioventricular block

(2d) ventricular tachycardia

(2e) premature ventricular contraction (over grade 2 in Lown's classification of premature ventricular tachycardia)

(2f) abnormal Q change

(2g) ST-T change

(3) one or more of the following:

(3a) abnormal wall motion, regional wall thinning or dilatation of the left ventricle

(3b) perfusion defect on 201-T1-myocardial scintigraphy or abnormal accumulation by 67-Ga-citrate or 99m-TC-PYP myocardial scintigraphy

(3c) abnormal intracardiac pressure, low cardiac output, abnormal wall motion of the left ventricle, or depressed ejection fraction of the left ventricle

(3d) interstitial fibrosis or cellular infiltration greater than moderate grade (even if the findings are nonspecific)


To read more or access our algorithms and calculators, please log in or register.