Subclinical Cardiac Dysfunction in Sarcoidosis (1)
Sarcoidosis is a clinical disorder of unknown cause, characterized by granulomatous infiltration of the lungs and other organs. In the heart, noncaseating granulomata can involve the ventricular septum, papillary muscles, and/or free ventricular walls in up to 30 percent of cases at autopsy. However, a discrepancy between clinical and autopsy finding exists, since only about 5 percent of all patients with sarcoidosis have clinically evident myocardial involvement, including heart block, ventricular ectopy, congestive cardiomyopathy, and syncope/sudden death. Interestingly, up to one third of patients with myocardial involvement found at autopsy do not have clinical evidence of cardiac sarcoidosis during life.2 The diagnosis can be confirmed by endomyocardial biopsy. buy cipro
Exertional dyspnea and easy fatigability are complaints often found in patients with sarcoidosis, even in the presence of normal lung function. We hypothesized that many patients with sarcoidosis have clinically unsuspected myocardial involvement that could affect cardiac performance when the heart is stressed, as with exercise. Exercise testing allows investigation of the mechanisms underlying these symptoms by examining ventilatory and cardiovascular responses to the stress of exercise. The purpose of this study was to characterize cardiovascular responses with exercise and activities of daily living in a population of patients with sarcoidosis to investigate the prevalence of abnormal cardiovascular responses, likely representing cardiac abnormalities in this population.