Involvement of the heart in sarcoidosis may be subclinical until the person dies suddenly or it may be misdiagnosed. The diagnosis may only be made at autopsy.
Manifestations of cardiac sarcoidosis prior to sudden cardiac death:
(1) atrioventricular block
(2) heart failure
(3) sustained ventricular tachycardia
(4) ventricular premature contractions or non-sustained ventricular tachycardia
(5) angina-like chest pain
Cardiac MRI may show late gandolinium enhancement.
Other causes of heart disease such as severe coronary arteriosclerosis may be present.
If the diagnosis can be made prior to death, then interventions (immunosuppression, ICD implantation) can improve 10-year survival.
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