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Heart Consult

Cardiac Sarcoidosis

Sarcoidosis is a disease triggered by an atypical collection of granulomas, the inflammatory cells that are formed as nodules in the organs of the human body. Sarcoidosis may occur in any organ of the body like lymph nodes, skin, eyes, joints, spleen, kidney, lungs, heart, salivary glands, etc. More than 90% of the sarcoidosis cases are found with inflammation in the lungs and this type is called as pulmonary sarcoidosis. Sarcoidosis involving the central nervous system is called as Neurosarcoidosis in which granulomas are found in various tissues. Neurosarcoidosis are found in only 1% of the patients and nearly 10% of the patients are affected by other sarcoidosis diseases. According to the studies on the disease sarcoidosis, the causes of sarcoidosis are unidentified and the Cardiac sarcoidosis is an uncommon one. 


Sarcoidosis Causes 
Cardiac specialists treat this disease under the hypothesis that sarcoidosis causes are due to the changes in the immune response of the human body, when a genetically vulnerable person is exposed to a different environment or the infectious agents like viruses and mycobacterium. Beryllium, zirconium and aluminium are some of the environmental exposure factors which may activate inflammatory immune responses in human body that leads to granuloma formations. Still, there are no well-defined reasons for Sarcoidosis causes. Actually, the effects of sarcoidosis disease vary from a benign ectopics heart beat problem to a major life threatening health issue like ventricular tachycardia.

Sarcoidosis Symptoms and Diagnosis
Early diagnosis is important for treating Cardiac sarcoidosis and Corticosteroids, a type of steroid hormones are needed for the patients affected by this disease.  Myocardial sarcoidosis may result in sudden cardiac death. Nearly 25% of the patients have cardiac granulomas as sarcoidosis symptoms. Other symptoms like syncope - the impermanent loss of consciousness, congestive heart problems like pumping system issues of heart, cardiac tamponade like fluid accumulation in the pericardium and breathing problems like dyspnea are found in the patients. Cardiac Sarcoidosis diagnosis practices are difficult since the exact cause is not known. Electrocardiogram is the initial screening test to confirm suspected sarcoidosis. Nearly 30% of the sarcoidosis patients have conduction disturbances arrhythmias in their ECG. Abnormalities on SC-T wave, right bundle branch block and premature supra-ventricular contractions are the key symptoms examined by doctors in sarcoidosis diagnosis process. 

Sarcoidosis Stages 
Different types of Cardiac Sarcoidosis stages can be identified by the various diagnoses systems. Patients will have swelling in the legs in the later stages of this disease. Holter monitoring, Echocardiography, Nuclear imaging, Positron emission tomography, Heart biopsy, etc are some of the methods followed by Cardiac specialists to diagnose various Cardiac sarcoidosis stages. The early stages of this disease can be found out by the symptoms of perfusion abnormalities and high inflammation problems. This disease is detected in four stages ranging from stage 0 to stage 4. In each stage, the lymph nodes are examined along with the chest x-rays and stage-4 is used to find the presence of scar tissues and to detect sarcoidosis.  

Sarcoidosis Prognosis and Treatments
In reality, a well-defined Cardiac Sarcoidosis prognosis is not available but in a 5-year research, clinicians have found that the mortality rates are higher than 50%. The treatments for this disease depend on the diagnoses of the symptoms and the severity or the stage of sarcoidosis. Common methods used in the treatments are corticosteroids and anti-inflammatory medications. With some randomized trials, cardio specialists prescribe Corticosteroids that are considered as mainstay for Sarcoidosis treatments. In these random trials, researchers have found some short-term responses but long-term effectiveness has not yet been recorded in treatments. Medication with steroids is followed for long terms and the patients are advised to take immunosuppressive agents like methotrexate, azathioprine and hydroxychloroquine which act as steroid-sparing agents. Apart from these medications, surgical related treatments like placing pace makers, resection of the affected parts and heart transplantations are also followed in the treatments of sarcoidosis.
 
Sarcoidosis Life Expectancy 
According to the various studies conducted, the life expectancy of the patients in the last stage of this disease is nearly two years after developments and the cardiac symptoms in their body. Some studies have reported that, more than 250 patients with Cardio sarcoidosis have survived for more than 5 years after the diagnosis of this disease. Most cardio sarcoidosis patients have died due to the complications and severity of this disease like ventricular tachyarrhythmia, conduction disturbances and cardiomyopathy problems. Some researches have reported 50% of the 3 year survivors and 72% of the 5 year survivors of this disease. However, an accurate evaluation of the Sarcoidosis life expectancy is still under research.

Sarcoidosis Support Groups
Medical professionals are concerned about the emotional hurdles faced by the Sarcoidosis patients. To avoid stress and to maintain a good mental health they advise the patients and their caretakers to be aware of these diseases and their effects. To help the patients many Sarcoidosis support groups have been formed, in almost all the developed countries. Their objective is to help people who have been affected by Sarcoidosis and to bring awareness about this disease in an effective way. They conduct campaigns to raise awareness among the affected people and to help the research studies about this disease. They share and discuss the various experiences, improvements in treatments, latest treatment methods, success stories, etc with their group members and other groups. Undoubtedly, these support groups help patients with sarcoidosis to face their health problems with a positive attitude.