Controversy exists as to the best treatment for cardiac sarcoidosis (CS). However, treatment is generally directed at minimizing the inflammation associated with CS and protecting against the life-threatening complications.
Because of their anti-inflammatory properties, corticosteroids (cortisone, prednisone and methylprednisolone) are the first-line therapy. When patients cannot take steroids, or when combination therapy is necessary, medications such as methotrexate, azathioprine, mycophenolate and antimalarials are used.
Additional therapies for specific CS-related heart disorders may be necessary. For example, heart rhythm disorders such as complete heart block typically require placement of a permanent pacemaker, whereas ventricular tachycardia generally requires internal cardiac defibrillator (ICD) placement.