Johns Hopkins cardiologist and cardiac sarcoidosis expert Nisha Gilotra, M.D., explains how sarcoidosis can affect the heart and outlines treatment options for this condition.

What is cardiac sarcoidosis?

Sarcoidosis is an inflammatory condition that can affect multiple organs. In cardiac sarcoidosis, tiny collections of immune cells form granulomas in the heart tissue and can interfere with normal functioning.

This can result in heart rhythm abnormalities, also known as arrhythmias, such as ventricular tachycardia or heart block. It can also lead to cardiomyopathy or heart failure.

What are the symptoms of cardiac sarcoidosis?

Symptoms of cardiac sarcoidosis include:

• Chest pain
• Fainting (syncope)
• Fatigue
• Irregular heartbeats (arrhythmias)
• Palpitations
• Shortness of breath
• Swelling in legs from fluid excess

Symptoms of cardiac sarcoidosis can be life-threatening.

Call 911 or go to the ER: If you have heart problems such as chest pains, shortness of breath or sudden numbness, get help immediately.

What causes cardiac sarcoidosis?

The cause of sarcoidosis is unknown, but researchers believe it results from an abnormal response of the body’s immune system. There may also be environmental and genetic predispositions.

How is cardiac sarcoidosis diagnosed?

Cardiac sarcoidosis can be difficult to diagnose and requires thorough testing, which may include the following:

• Electrocardiogram
• Event monitor
• Echocardiogram
• Cardiac MRI
• PET scan
• Right heart catheterization
• Cardiac biopsy

How is cardiac sarcoidosis treated?

Medications usually include immunosuppression such as steroids and cardiac-specific medication if you have arrhythmias or heart failure. Additionally, patients may require the following cardiac procedures:

• Implantable cardioverter defibrillator (ICD)
• Pacemaker
• Catheter ablation
• Heart transplant/left ventricular assist device

Am I at risk for developing cardiac sarcoidosis?

Cardiac sarcoidosis can develop in all ethnicities and ages, but there are certain things that may put some people at higher risk. For example, sarcoidosis is more common in patients ages 20–60 and in those of African American or Northern European ethnicity.