Sarcoidosis can cause sudden death if it involves the heart. The diagnosis may be missed if certain information is not available.
Sudden death in cardiac sarcoidosis is often ascribed to involvement of the cardiac conduction system.
Reasons that a diagnosis of cardiac sarcoidosis may be missed:
(1) The patient does not have a history of sarcoidosis.
(2) The noncaseating granulomatous inflammation is limited or not identified.
(3) The cardiac exam is limited, especially along the cardiac conducting system.
(4) Inflammation and/or fibrosis is misinterpreted as another form of cardiomyopathy.
In cases of unexplained sudden death:
(1) cardiac sarcoidosis should always be suspected
(2) multiple sections should be taken of the heart, especially along the conduction system
(3) noncaseating granulomas should be looked for in other organs
