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Cardiac Sarcoidosis: Symptoms

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This information was reviewed and approved by Howard D. Weinberger, MD, FACC (3/1/2021).

How Can Sarcoidosis Affect the Heart and other Symptoms?

Cardiac sarcoidosis can have many symptoms and take many forms. Some are benign, and others are serious.

Some of the most common cardiac sarcoidosis symptoms include:

  • Syncope (lightheadedness or fainting)
  • Shortness of breath
  • Coughing
  • Chest tightness or chest pain
  • Fast or irregular heartbeat

These and other symptoms are linked to the possible forms and complications of cardiac sarcoidosis, which include:

Heart Rhythm Disorders

A complete block of electrical movement through the heart (heart block) is one of the most common form of sarcoidosis of the heart. Alternatively, fast heart rhythms such as atrial flutter, atrial fibrillation, supraventricular tachycardia and ventricular tachycardia can be present. Ventricular tachycardia occurs in almost 25 percent of people with cardiac sarcoidosis. It is of particular concern, since it can lead to sudden cardiac death. These possible complications may occur suddenly and without warning.


Heart Failure

Heart failure is another complication of cardiac sarcoidosis. Sarcoidosis can cause the heart muscle to weaken and/or stiffen. This leads to fluid retention in the lungs, abdomen and lower extremities. In extreme cases, an aneurysm can form due to weakening of the heart wall. Granulomas can also infiltrate the heart valves resulting in abnormal heart valve function.


Coronary Disease

Although rare, sarcoidosis of the heart can cause an inflammatory disorder of the heart arteries called vasculitis. In severe forms, vasculitis can lead to coronary artery blockages, chest pain and, ultimately, heart attacks.


Pericardial Disease

Inflammation of the sac around the heart, called pericarditis, is another rare but important form of cardiac sarcoidosis.


Pulmonary Hypertension

Pulmonary hypertension is high blood pressure in the lung arteries which can be a direct results of sarcoidosis affecting the lung arteries, or from lung problems such as sarcoidosis. Pulmonary hypertension may cause shortness of breath, decreased exercise capacity, chest pain and other symptoms.

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