020 3389 7221 info@sarcoidosisuk.org
選擇頁面

SARCOIDOSIS和心臟

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.

此頁面上的信息是在結節病專家的幫助下編制的 L. Williams博士S. Agarwal博士,顧問心髒病專家, K. Tweed博士,顧問放射科醫師和 M. Thillai博士,顧問胸科醫師(所有心臟結節病單位,皇家帕普沃斯醫院)及其他評論 M. Wickremasinghe博士,呼吸科醫生和顧問 A. Varnava博士,顧問心髒病專家(帝國理工學院醫療保健NHS信託基金會)。

結節病和心髒病

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.

心臟結節病

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.

症狀:

Symptoms of cardiac sarcoidosis include:

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

肺動脈高壓

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.

了解您的情況的技巧

大多數新診斷的結節病患者將有心電圖,動態心電圖監測和超聲心動圖。疑似心臟結節病患者可能會繼續進行進一步的診斷測試。其中大部分描述如下。

心電圖(心電圖):  這提供了有關心臟電傳導系統以及心率和心律的信息。 

Echocardiogram (Echo):  這使用超聲波來產生圖像,其顯示肌肉心室的泵送功能和心臟瓣膜的功能。它還允許測量心臟血管內的血壓(以尋找肺動脈高壓)。

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).

臨床電生理學研究:  導管用於繪製心臟的傳導系統。這可以揭示可能導致異常緩慢心率的異常,以及可能由炎症或瘢痕區域引起的任何異常快速或危險的心律。

Right Heart Catheterisation:  該測試使用探針測量心臟和附近血管中的壓力,以確定肺動脈高壓的累及。

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.

這些藥物可以抑制炎症,但不能治療心臟本身。

Treatment: Cardiac Sarcoidosis

及時診斷和用藥物治療對預後良好很重要。

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)

可以考慮心臟移植。這是非常罕見的。

Treatment: Pulmonary Hypertension

藥物可以減輕症狀並改善血管的壓力。

你可能會被處方:

  • 利尿劑,
  • 內皮素拮抗劑
  • 前列環素。

可考慮進行肺移植。這是非常罕見的。

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

來自SarcoidosisUK的相關內容:

結節病和疲勞

你經歷過疲勞嗎?查找有關結節病和疲勞的症狀,治療和更多信息。

顧問目錄

你想找個顧問嗎?使用我們的目錄查找您附近的結節病專科醫生或診所。

結節病UK支持

我們怎能支持你?有關我們的護士幫助熱線,支持小組和在線支持的更多信息。

分享這個