The role of diagnostics of arrhythmias and conduction disturbances, heart failure in prognosis of patients with cardiac sarcoidosis

Abstract

Cardiac sarcoidosis is a chronic inflammatory disease characterized by non-caseating patchy granulomatous lesions of the heart with suspected immunopathological response to an unidentified antigenic trigger in a genetically susceptible individual. Cardiac sarcoidosis is known to be the second most common cause of death in sarcoidosis patients globally. Sarcoidosis often occurs as a systemic inflammation with multi-organ involvement, although, rarely it can occur in isolated forms. The above-mentioned particular phenotype is difficult to diagnose as it requires exclusion of a number of other diagnoses and when left untreated can progress to fibrosis while cardiac dysfunction eventually leads to sudden cardiac death, which encourages the researchers and clinicians to modify a new framework of diagnostic modalities and management tactics. Depending on the prevalence and severity of a particular phenotype of the disease, the clinical picture can vary from an asymptomatic form to severe fatal cardiac manifestations such as decompensated heart failure, severe forms of ventricular and atrial malignant arrhythmias, conduction abnormalities and sudden cardiac death. Therefore, early diagnosis and timely initiation of the treatment tactics including immuno-suppressive medicine remain crucial to combat this pathological condition.