Cardiac sarcoidosis - a possible cause of death. Case report

The incidence of cardiac sarcoidosis is more then 5% from the patients with chronic sarcoidosis and the survival is between 2 and 5 years. The diagnosis must be precocious and the treatment aggressive for increasing life expectancy. We describe the case of a 72 years old male with pulmonary and lymph node sarcoidosis which required surgical intervention. The histological examination revealed non caseous granulomatous inflammation in the mediastinal nodes and epithelioid cardiac granulomas without myocyte necrosis. Six month later the patient developed progressive heart failure and after one year the cardiac examination revealed multiple cardiac lesions. The diagnosis of cardiac sarcoidosis is often difficult to confirm when the cardiac dysfunction is the only sign because of the lack of specific diagnosis tests. A diagnosis guide that includes histological and clinic criteria. The diagnosis must be sustained by invasive and non-invasive methods. Cardiac sarcoidosis remains a challenge by the unforeseeable evolution to death. Sudden death is common in cardiac sarcoidosis, often noiseless clinically.