020 3389 7221 info@sarcoidosisuk.org
Vælg en side

SARCOIDOSIS OG HJERTET

The heart can be affected by sarcoidosis in two ways. Firstly, sarcoidosis can occur in the heart muscle itself (cardiac sarcoidosis). Secondly, the heart may be indirectly affected as a result of sarcoidosis in the lungs (pulmonary hypertension). Both conditions can have serious consequences.

Oplysningerne på denne side er blevet udarbejdet ved hjælp af sarcoidose specialister Dr. L. Williams & Dr. S. Agarwal, Konsulent kardiologer, Dr. K. TweedRådgiver Radiolog og Dr. M. Thillai, Konsulentbrystlæge (alle kardial Sarcoidosis Unit, Royal Papworth Hospital) med yderligere kommentarer fra Dr. M. Wickremasinghe, Konsulent åndedrætslæge og Dr. A. Varnava, Konsulentkardiolog (begge Imperial College Healthcare NHS Trust).

Sarcoidose og hjertet

The heart can be affected by sarcoidosis in two ways. Firstly, sarcoidosis can occur in the heart muscle itself (cardiac sarcoidosis). Secondly, the heart may be indirectly affected as a result of sarcoidosis in the lungs (pulmonary hypertension). Both conditions can have serious consequences.

Kardial Sarcoidose

Cardiac sarcoidosis occurs when the heart muscle itself is affected. The accumulation of immune cells causes clumps of tissue called granulomas. These can occur in the heart in different places:

• left or right ventricles and interventricular septum (wall in-between the ventricles)
• papillary muscles (connected to the heart valves)
• pericardium (thin sac lining the heart)
• cardiac conduction system (muscles regulating the heart beat)
• and less often the left or right atrium (upper chamber)

Cardiac sarcoidosis occurs in up to a third of all sarcoidosis patients, but only causes specific symptoms in around 5% of cases.

Symptomer:

Symptoms of cardiac sarcoidosis include:

  • irregular heartbeat (pounding or fluttering sensation, or a ‘skipping of beats’)
  • dizziness and/or fainting spells
  • shortness of breath
  • brystsmerter
  • swelling of the legs (in later stages)

Pulmonal hypertension

Pulmonary sarcoidosis (sarcoidosis of the lungs) can also indirectly affect heart function. Abnormalities of the lungs, and of the blood vessels between the lungs and the heart, can cause an increase in the pressure within the blood vessels in the lungs (pulmonary hypertension). This pressure can then overload the right ventricle. This can occur in up to 15% of all patients with sarcoidosis.

Teknikker til at forstå din tilstand

De fleste nyligt diagnosticerede sarcoidose patienter vil have et EKG, holter monitor og ekkokardiogram. Mistanke om hjerteskarcoidose patienter kan fortsætte med at få yderligere diagnostiske tests. De fleste af disse er beskrevet nedenfor.

EKG (elektrokardiogram):  Dette giver information om hjertets elektriske ledningssystem samt hjertefrekvens og hjerterytme. 

Echocardiogram (Echo):  Dette bruger ultralydbølger til at skabe billeder, der viser pumpefunktionen i de muskulære hjertekamre og hjerteventilernes funktion. Det tillader også måling af blodtrykket i hjerteskærerne (for at søge lunghypertension).

Magnetic Resonance Imaging (MRI):  This scan can identify involvement of sarcoidosis in the heart. Usually you will be injected with a special dye to show any changes to the soft tissue in the heart muscle. MRI images also provide information about heart function.

Nuclear Scans: Thallium scans and PET scans create images that can identify any active inflammation within the heart muscle and can help to guide treatments. For the cardiac PET scan it is important that a strict diet is kept to in the days before the scan (this will be explained to you beforehand).

Holter monitor:  A holter monitor is a small, portable ECG device that takes a continuous recording of your heart rhythm over a longer period of time (usually 24 hours but sometimes longer). It is particularly useful to identify any evidence of problems in the conduction system of the heart (e.g. very fast or slow heart beats or any abnormal rhythms).

Kliniske elektrofysiologi studier:  Et kateter bruges til at kortlægge hjertets ledningssystem. Dette kan afdække abnormiteter, som kan prædisponere unormalt langsomt hjertefrekvens, samt eventuelle unormalt hurtige eller farlige hjerterytmer, som kan opstå i områder med inflammation eller ardannelse.

Right Heart Catheterisation:  Denne test anvender en probe til at måle trykket i hjertet og i de nærliggende blodkar for at bestemme inddragelse af lungehypertension.

Biopsy of the Heart: This is rare and only used when there is a specific reason to do so. Patients who have had a lung biopsy will usually not need a heart biopsy or any further biopsies.

Blood Samples: The following may be tested:

  • angiotensin converting enzyme (ACE)
  • brain natriuretic peptide (BNP)
  • troponin

Treatment: Cardiac Sarcoidosis and Pulmonary Hypertension

Your doctor may prescribe medication to suppress the sarcoidosis:

• Corticosteroids (usually prednisolone tablets) may be used for a number of years. Some patients may require low doses longer term, in combination with other forms of immunosuppression. In severe cases intravenous steroids may be used first before switching to tablets.
• Other medicines that suppress the immune system, for example: methotrexate, mycophenolate or azathioprine.

Disse lægemidler undertrykker betændelsen, men medicinerer ikke selve hjertet.

Treatment: Cardiac Sarcoidosis

Tidlig diagnose og behandling med medicin er vigtig for en gunstig prognose.

You may be prescribed the following to help regulate heart rhythm or to treat any heart failure:

• specific heart medications (tablets)
• implant a pacemaker or defibrillator (ICD)

Hjertetransplantation kan overvejes. Dette er meget sjældent.

Treatment: Pulmonary Hypertension

Medicin kan reducere symptomer og forbedre trykket i blodkarrene.

Du må ordineres:

  • diuretika,
  • endothelin-antagonister,
  • prostacycliner.

Lungetransplantation kan overvejes. Dette er meget sjældent.

Page last updated: July 2019. Next review: July 2021.

Relateret indhold fra SarcoidosisUK:

Sarcoidose og træthed

Oplever du træthed? Find symptomer, behandling og mere information om sarkoidose og træthed.

Konsulentkatalog

Ønsker du at finde en konsulent? Brug vores katalog til at finde en sarkoidos specialist eller klinik i nærheden af dig.

SarcoidosisUK Support

Hvordan kan vi støtte dig? Find mere information om vores sygeplejerskehjælpeplan, supportgrupper og online support.

Del dette