020 3389 7221 info@sarcoidosisuk.org
Atlasiet lapu

SARCOIDOSIS UN SIRTS

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.

Šajā lapā sniegtā informācija ir apkopota ar sarkoidozes speciālistu palīdzību Dr L. Williams & Dr. S. Agarvāls, Kardiologu konsultants, Dr K. Tweed, Konsultants radiologs un Dr M. ThillaiKonsultants krūšu kursa ārsts (visas sirds sarkobozes vienība, Royal Papworth slimnīca) ar papildu komentāriem Dr Wickremasinghe, Konsultantu elpošanas ārsts un Dr A. Varnava, Kardiologa konsultants (gan Imperial College Healthcare NHS Trust).

Sarkoidoze un sirds

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.

Sirds sarkoidoze

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.

Simptomi:

Symptoms of cardiac sarcoidosis include:

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

Plaušu hipertensija

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.

Jūsu stāvokļa izpratnes metodes

Lielākajai daļai nesen diagnosticētu sarkoidozes pacientu būs EKG, holtera monitors un ehokardiogramma. Aizdomās turētie sirds sarkoidozes pacienti var turpināt diagnostikas testus. Lielākā daļa no tām ir aprakstītas turpmāk.

EKG (elektrokardiogramma):  Tas sniedz informāciju par sirds elektriskās vadīšanas sistēmu, kā arī sirds ritmu un sirds ritmu. 

Echocardiogram (Echo):  Tas izmanto ultraskaņas viļņus, lai izveidotu attēlus, kas parāda muskuļu sirds kameru sūknēšanas funkciju un sirds vārstuļu darbību. Tas arī ļauj mērīt asinsspiedienu sirds asinsvados (meklēt plaušu hipertensiju).

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).

Klīniskās elektrofizioloģijas pētījumi:  Katetru izmanto, lai kartētu sirds vadīšanas sistēmu. Tas var atklāt novirzes, kas var izraisīt neparasti lēnu sirdsdarbības ātrumu, kā arī jebkādus neparasti ātrus vai bīstamus sirds ritmus, kas var rasties iekaisuma vai rētas rašanās vietās.

Right Heart Catheterisation:  Šis tests izmanto zondi, lai izmērītu spiedienu sirdī un tuvākajos asinsvados, lai noteiktu plaušu hipertensijas iesaistīšanos.

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.

Šīs zāles nomāc iekaisumu, bet neārstē pašu sirdi.

Treatment: Cardiac Sarcoidosis

Laicīga diagnoze un ārstēšana ar medikamentiem ir svarīga labvēlīgai prognozei.

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)

Var apsvērt sirds transplantāciju. Tas ir ļoti reti.

Treatment: Pulmonary Hypertension

Zāles var samazināt simptomus un uzlabot spiedienu asinsvados.

Jums var būt noteikts:

  • diurētiskie līdzekļi,
  • endotelīna antagonisti,
  • prostaciklīniem.

Var apsvērt plaušu transplantāciju. Tas ir ļoti reti.

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

Saistīts saturs no SarcoidosisUK:

Sarkoidoze un nogurums

Vai jums ir nogurums? Atrodiet simptomus, ārstēšanu un vairāk informācijas par sarkoidozi un nogurumu.

Konsultantu katalogs

Vai vēlaties atrast konsultantu? Izmantojiet mūsu direktoriju, lai atrastu sarkoidozes speciālistu vai klīniku pie jums.

SarcoidosisUK atbalsts

Kā mēs varam jūs atbalstīt? Plašāka informācija par mūsu medmāsas palīdzības dienestu, atbalsta grupām un tiešsaistes atbalstu.

Dalīties ar šo