Guidelines for the diagnosis of cardiac sarcoidosis

Histologic diagnosis

Endomyocardial biopsy demonstrating noncaseating epithelioid granulomas

Clinical diagnosis

Among patients with a histologic diagnosis of extracardiac sarcoidosis, cardiac sarcoidosis should be suspected when criterion "a" and at least one of criteria "b" to "e" is present in patients in whom other causes such as hypertension and coronary heart disease have been excluded:

a. Complete right bundle branch block, AV block, ventricular tachycardia, ventricular premature beats or pathologic Q wave or ST-T changes on the electrocardiogram

b. Abnormal wall motion, regional wall thickening, or left ventricular dilation

c. Perfusion defect on myocardial perfusion imaging or abnormal accumulation of 67-Gallium citrate or 99mTc-PYP myocardial scintigraphy

d. Abnormal intracardiac pressure, low cardiac, or abnormal wall motion or reduced ejection fraction of the left ventricle

e. On endomyocardial biopsy, interstitial fibrosis or more than moderate cellular infiltration, even if the findings are nonspecific

Diagnosis_cardiac_sarcoidos.htm

Adapted from Hiraga H, Yuwai K, Hiroe M, et al. Guidelines for the diagnosis of cardiac sarcoidosis: Study Report of Diffuse Pulmonary Diseases. The Japanese Ministry of Health and Welfare 1993; p. 23.

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Guidelines for the diagnosis of cardiac sarcoidosis