0201: Cardiac involvement in patients with sarcoidosis

Introduction Sarcoidosis is a systemic granulomatous disease of unknown etiology. Cardiac involvements in patients with sarcoidosis are rare with an estimated prevalence of 7%. These serious involvements are hard to diagnose at early stage of disease. Patients and Methods We performed a retrospective study of patients’ files diagnosed with sarcoidosis in the Internal Medicine Department of Rabta University Hospital in Tunis. The diagnosis of sarcoidosis was based on clinical, paraclinical and histological criteria. Cardiac involvements were confirmed by the electrocardiogram and echocardiography. Results Cardiac involvement (CI) was found in seven patients among 138 with sarcoidosis (5%). They were 6 females and one male with a mean age at diagnosis of 49 years. Electrical disorders such as bundel branch block were seen in two cases. First degree atrioventricular block was noted in two cases. Ventricular hypertrophy was check out in two cases by electrocardiography and ultrasound. Mitral regurgitation with a flutter was noted in one patient and pericardial effusion with a normal ventricular function in another case. Only one patient was clinically symptomatic, he complained of palpitations. Thallium 201 scintigraphy was performed in one case and objectived reversible ischemia of the inferior and latero-inferior walls of myocardium. Other manifestations of sarcoidosis were dominantly associated to CI such as lung disease, which was found in all patients. Skin and neurological involvement were observed, each in three cases. Hepatosplenic involvements were noted in two patients and otorhinolaryngology involvements in one case. All patients received initially high dose of corticosteroids. Four of the patients had a good response to treatment and three were lost to follow up. Conclusion Cardiac involvements in sarcoidosis are rare but serious, an early diagnosis and treatment with corticosteroid may rapidly improve patients.