Sarcoidosis
Definition
Multisystem granulomatous disease: involves the heart in about 25% of cases
Signs and Symptoms
- Progressive heart failure
Complications
- Sudden death
Electrocardiogram
- Complete heart block
- Ventricular dysrhythmias
Chest X-ray
- Bilateral hilar lymphadenopathy
M-Mode/2-D
- Increased left ventricular wall thickness (early)
- Segmental wall thinning (late)
- Segmental wall contraction abnormalities (late)
- Left ventricular enlargement with decreased ejection fraction (late)
- Aneurysm (late)
Doppler
- Normal or slightly increased mitral E velocity
- No significant respiratory variation in mitral E velocity
- Rapid mitral deceleration time < 160 msec), especially during inspiration
- Diastolic mitral and tricuspid regurgitation
- Normal to slightly decreased left ventricular isovolumic relaxation time
- Small mitral A wave
- Increased mitral E/A ratio (>2.0)
- Decreased tricuspid valve deceleration time with inspiration
- Decreased systolic and increased diastolic filling in pulmonary veins
- Systolic reversal in inspiration and A wave reversal and late diastolic reversal in hepatic vein
- Mitral regurgitation