Diagnostic and Therapeutic Management of Cardiac Sarcoidosis -Application of High Resolution Electrocardiography

Sarcoidosis is a common multisystem granulomatous disease of unknown etiology. Overall the prognosis is not necessarily deleterious because organ involvement is usually asymptomatic except for ocular or cutaneous involvements and the disease is often selflimiting. Cardiac Sarcoidosis is rare (5%) but once the heart is involved, the patient’s prognosis is poor because of the development of fatal arrhythmias, atrioventricular conduction disturbance or refractory congestive heart failure (Newman et al., 1997). Despite advanced research, a clear cause and pathogenesis for sarcoidosis remains unknown. Sarcoidosis is thought to be caused by an abnormal, exaggerated response of the immune system. Infectious agents such as Propionibacterium acnes, Mycobacteria suspected of causing sarcoidosis (Nishiwaki et al., 2004; Hance, 1998) , but The American Thoracic Society's wide-ranging Statement on Sarcoidosis suggested that there is no clear evidence of an infectious agent causing sarcoidosis. Genetic factors such as the human leucocyte antigens (specifically HLA-DRB1) may be a predisposition for sarcoidosis (Maliark et al., 1998), but not the only cause. Currently, sarcoidosis is considered to be caused by multiple factors.