Tan Jian Liang, Tan Bryan E-Xin, Cheung Jim W, Ortman Matthew, Lee Justin Z
Division of Cardiovascular Disease, Cooper University Health Care/Cooper Medical School of Rowan University, Camden, New Jersey.
Department of Internal Medicine, Rochester General Hospital, Rochester, NY.
Trends Cardiovasc Med. 2023 Oct;33(7):442-455. doi: 10.1016/j.tcm.2022.04.007. Epub 2022 Apr 30.
Cardiac sarcoidosis is an inflammatory myocardial disease of unknown etiology. It is characterized by the deposition of non-caseating granulomas that may involve any part of the heart. Cardiac sarcoidosis is often under-diagnosed or recognized partly due to the heterogeneous clinical presentation of the disease. The three most frequent clinical manifestations of cardiac sarcoidosis are atrioventricular block, ventricular arrhythmias, and heart failure. A definitive diagnosis of cardiac sarcoidosis can be made with histology findings from an endomyocardial biopsy. However, the diagnosis in the majority of cases is based on findings from the clinical presentation and advanced imaging due to the low sensitivity of endomyocardial biopsy. The Heart Rhythm Society (HRS) 2014 expert consensus statement and the Japanese Ministry of Health and Welfare criteria are the two most commonly used diagnostic criteria sets. This review article summarizes the available evidence on cardiac sarcoidosis, focusing on the diagnostic criteria and stepwise approach to its management.
心脏结节病是一种病因不明的炎症性心肌疾病。其特征是出现非干酪样肉芽肿沉积，可累及心脏的任何部位。心脏结节病常因临床表现的异质性而诊断不足或部分被认识。心脏结节病最常见的三种临床表现是房室传导阻滞、室性心律失常和心力衰竭。心脏结节病的确诊可依据心内膜活检的组织学结果。然而，由于心内膜活检的敏感性较低，大多数病例的诊断基于临床表现和先进影像学检查结果。心脏节律协会（HRS）2014年专家共识声明和日本厚生省标准是两个最常用的诊断标准集。这篇综述文章总结了关于心脏结节病的现有证据，重点关注诊断标准及其管理的逐步方法。
