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Cardiac Sarcoidosis and Inflammatory Heart Disease

The Cardiac Sarcoidosis and Inflammatory Heart Disease Program is one of the few programs in the country exclusively dedicated to the evaluation and treatment of patients with suspected or confirmed cardiac sarcoidosis and inflammatory heart disease. A multidisciplinary team of specialists collaborate to provide the most appropriate and effective care for patients with cardiac sarcoidosis and inflammatory heart disease.

What is sarcoidosis?

Sarcoidosis is a rare inflammatory disease of adults that can occur in almost any organ. It affects the lungs (pulmonary sarcoidosis) in 90 percent of patients. Sarcoidosis can affect the heart in about 20 percent of patients and is called cardiac sarcoidosis.

What are the risk factors for sarcoidosis?

The cause of sarcoidosis remains unknown.

What are the symptoms of cardiac sarcoidosis?

Sarcoidosis can be difficult to diagnose because symptoms often do not appear in the early stages and when they do, they can mimic other diseases. When sarcoidosis appears in the heart (cardiac sarcoidosis), patients may experience:

  • Palpitations (feeling like your heart has skipped or added a beat)
  • Shortness of breath
  • Fatigue
  • Lightheadedness
  • Dizziness
  • Fainting

How is cardiac sarcoidosis diagnosed?

Cardiac sarcoidosis can be challenging to diagnose because symptoms can often mimic those of other diseases.

To effectively diagnose sarcoidosis, your physicians will review any results from tests you have already had done and may recommend others (see services below). These can include imaging studies and biopsies, among other tests.

What is the treatment for cardiac sarcoidosis?

If your symptoms are not severe, treatment may not be necessary and the disease may resolve on its own. This is the case for many patients diagnosed with sarcoidosis, including some patients with cardiac sarcoidosis. Follow up is required to ensure that your sarcoidosis does not worsen. If the disease affects organ or your quality of life, medication and lifestyle changes can make a difference.

Your multidisciplinary medical team at our center will recommend an individualized treatment plan which may include:

Medications

  • Anti-inflammatory drugs
  • Immunosuppressive agents
  • Newer biologic therapies
  • Heart medications (such as beta-blockers, renin angiotensin system inhibitors and/or diuretics) to reduce strain on the heart, help the heart beat stronger and more regularly, and/or reduce fluid in the body

Lifestyle

  • Stopping smoking and alcohol consumption
  • Weight loss
  • Reducing fat and salt in your diet
  • Exercise and stress reduction
  • Blood pressure control

Additionally, if your cardiac sarcoidosis has caused heart rhythm issues (arrhythmias), we may recommend one or more of the following:

  • An electrophysiology study
  • A ventricular tachycardia (VT) ablation
  • Placement of an implantable cardioverter defibrillator (ICD)
  • Placement of a permanent pacemaker

In the rare situation when sarcoidosis has severely damaged your heart, a left ventricular assist device (LVAD) and/or heart transplant may be necessary. The Brigham and Women’s Heart Transplant and Mechanical Circulatory Support Program provides innovative and compassionate care to our patients with advanced heart disease.

What questions can the Cardiac Sarcoidosis Program answer?

Here is a list of common questions that patients and their families have when they come to see us and that we are able to answer:

  • Do I have cardiac sarcoidosis? Does it involve other organs?
  • If it is not cardiac sarcoidosis, what could it be?
  • Is there a test that could help determine if I have cardiac sarcoidosis?
  • What are my treatment options?
  • How will you know if the cardiac sarcoidosis is responding to treatment?
  • I have not responded to a few treatments, what other options are there?
  • Can I come off of my treatment?
  • Do I need to have a permanent pacemaker or implantable cardioverter defibrillator (ICD) placed?
  • Do I need to undergo an electrophysiology study (EPS)?
  • Do I need to undergo a ventricular tachycardia (VT) ablation?
  • Should I undergo evaluation for a left ventricular assist device (LVAD) or heart transplant?

What services does the Brigham provide?

The program provides both consultations and long-term cardiovascular care to patients with cardiac sarcoidosis and inflammatory heart disease. Our team members provide personalized recommendations directly to patients after their cases are discussed at a multidisciplinary conference. Patients have access to a wide array of services at Brigham and Women’s Hospital if their care/condition requires, including:

What should I expect?

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from Brigham and Women’s Hospital’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.

Who provides care for cardiac sarcoidosis?

The Cardiac Sarcoidosis and Inflammatory Heart Disease Program has team members from many different divisions, including:

  • Cardiovascular medicine
  • Electrophysiology
  • Pulmonology
  • Rheumatology
  • Neurology
  • Dermatology
  • Ophthalmology
  • Radiology
  • Pathology
  • Immunology
  • Allergy
  • Gastroenterology, Hepatology, and Endoscopy

Learn more about our team and the services they provide.

How request an appointment or find directions?

Please call (857) 307-4000 or email Dr. Sanjay Divakaran if you would like more information about the Cardiac Sarcoidosis and Inflammatory Heart Disease Program, or would like to schedule an appointment. We are located at:

Shapiro Cardiovascular Center
Heart & Vascular Center
Brigham and Women’s Hospital
70 Francis Street
Boston, MA 02115

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