Treatment and management of cardiac sarcoidosis

Abstract

Introduction: Sarcoidosis is a multisystem disease characterised by granulomas that may affect any organ. The causes of sarcoidosis remain poorly understood, but it might be influenced by genetic predisposition, immune dysregulations and environmental factors (Arkema and Cozier, 2018). Cardiac sarcoidosis (CS) is a potentially life-threatening condition characterised by formation of granulomas in the heart. The clinical presentation is highly variable from asymptomatic to palpitations, syncope, heart block, arrhythmia, cardiac pump failure or even sudden death (Hamzeh et al., 2015). Aim: The aim of this review is to provide an overview for nurses and allied health professionals of the treatment and management of cardiac sarcoidosis. Methods: A systematic review was conducted using the following databases: CINAHL, BNI, AMED, MEDLINE, EMBASE, PsycINFO, Cuiden Plus, Scopus, Cochrane Library, JBI, Campbell Library, and Web-of-Science. Results: The management of cardiac sarcoidosis is guided by individual symptoms, tolerance and response to treatment. These options may include: a) inmunosupression therapy, b) antiarrhytmic medication, c) catheter ablation, d) pacemaker implantation, e) implantable cardioverter defibrilator (ICD), f) heart transplantation. Conclusion: The management of active cardiac sarcoidosis (CS) requires regular follow-up to assess patients’ response to their individualised treatment plan. Furthermore, clinical monitoring is important to detect changes or early recurrence of CS. Cardiac specialist nurses are vital to coordinate the management and monitoring of CS, to facilitate communication between CS-patients and CS-clinicians, and to minimise the impact of CS in patients’ quality of life.