Description
The diagnosis that arrives too late
Cardiac sarcoidosis is usually found after a complete heart block in a young patient, or a ventricular arrhythmia, or at post-mortem. It is rarely found from the earlier abnormality that should have raised the question — because that abnormality looks unremarkable unless it is already on your mind.
These 392 pages exist to put it on your mind.
What should prompt suspicion
Unexplained conduction disease in a patient under fifty. Ventricular arrhythmia with no obvious substrate. Regional wall motion abnormality in a non-coronary distribution. Unexplained cardiomyopathy with pulmonary findings nobody connected. None is rare enough to ignore, and each is specific enough to justify looking further.
When the definitive test is not available
FDG-PET is the reference investigation and is unavailable to a large share of clinicians worldwide. The book is unusually practical here: what cardiac MRI can and cannot establish on its own, what a combination of clinical findings supports, and when it is worth referring a patient a long distance for imaging versus treating on the balance of evidence.
Beyond sarcoid
Across 31 chapters: lupus, rheumatoid disease, systemic sclerosis, vasculitis, IgG4-related disease, eosinophilic myocarditis, and overlap with amyloid. Immunosuppression decisions and device candidacy.
Suits
Cardiologists, rheumatologists, general physicians and imaging specialists.
PDF, lifetime access, from CardiologyBooks.com.
Suspecting it in time
Cardiac sarcoidosis is usually diagnosed late because its presentations belong to other diagnoses: unexplained high-grade block in a younger adult, ventricular arrhythmia with a mildly abnormal ventricle, or a cardiomyopathy attributed to another cause. The book gives the specific triggers that should prompt dedicated imaging and the diagnostic pathway through cardiac MRI, FDG-PET and biopsy, with the limitations of each stated.
The wider autoimmune group
Beyond cardiac sarcoidosis, the text covers cardiac involvement in systemic lupus, systemic sclerosis, rheumatoid disease, IgG4-related disease, eosinophilic granulomatosis and immune checkpoint inhibitor myocarditis. Immunosuppression decisions, the timing of device implantation relative to treatment response, arrhythmia management and transplant referral are each addressed, along with the shared care arrangement with rheumatology that these conditions require.
