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What is cardiac sarcoidosis?

Sarcoidosis is a disease that leads to inflammation and clustering of immune system cells in various organs of the body. It has no known cause. These immune cell clusters, or granulomas, most commonly form in the lungs, skin, and/or lymph nodes. It’s much rarer for them to occur in the heart; but when they do, the inflammation may damage or disrupt the function of the heart’s muscle, electrical system, arteries or valves,

Diagnosis

Cardiac sarcoidosis can be difficult to diagnose, especially if the patient does not have sarcoidosis in other organs

Accurate diagnosis depends on the use of advanced, non-invasive, imaging modalities such as cardiac MRI and FDG PET/CT scans. In some cases a lung or heart biopsy may be required.

St George’s Joint Cardiac Sarcoidosis

The clinic is run by Dr Raminder Aul (Consultant Respiratory Physician) and Dr Nesan Shanmugam (Consultant Cardiologist), both leading experts in the field of sarcoidosis.

A comprehensive respiratory and cardiac assessment is performed:

  1. Clinical assessment
  2. Initial selection of appropriate respiratory and cardiac investigations:
  • Blood tests – including serum electrolytes and B-type natriuretic peptide
  • Chest CT scan
  • Lung function tests
  • Electrocardiogram  (an instantaneous record of your heart’s electrical activity that tells us if there are any problems with your heart’s rhythm)
  • Echocardiogram (an ultrasound of the heart chambers and valves)
  • 24-hour ECG (Holter) monitoring test
  • Cardiac MRIIf there are suggestive features of cardiac sarcoidosis, an FDG-PET/CT scan is performed. This state-of-the-art test is highly sensitive in detecting cardiac inflammation. 
  • Management
  • The tests, once completed, are reviewed by our multidisciplinary team and the results and management plan discussed with the patient.

Sarcoidosis can’t currently be cured, but it can be managed to prevent other problems, such as heart failure, from developing over time. Treatment is directed at reducing inflammation and managing any heart problems caused by inflammation and granulomas. This often involves a regimen of anti-inflammatory drugs and lifestyle changes, and, in some circumstances, may also mean other steps like the implantation of a pacemaker.

A Collaborative Approach to Care

The cardiac sarcoidosis team includes specialists in the following areas:

  • Heart Failure Specialists
  • Electrophysiologists
  • General Cardiologists
  • Interventional Cardiologists
  • Cardiovascular Imaging Specialists
  • Cardiothoracic Surgeons
  • Respiratory Physicians

Referrals

We accept referrals of patients with clinically suspected or proven cardiac sarcoidosis for further evaluation and management plans.

If you need to refer a patient to us, please send your referral letter to

Dr Nesan Shanmugam, Consultant Cardiologist.

Useful links

https://www.nhs.uk/conditions/sarcoidosis

https://www.sarcoidosisuk.org/

https://www.stopsarcoidosis.org/