Cardiac Sarcoidosis: The Rare Inflammatory Condition That Affects the Heart

December 20, 2025

Cardiac Sarcoidosis: The Rare Inflammatory Condition That Affects the Heart

Verified By
KIMS-SUNSHINE
Specialist,
20 December, 2025

Cardiac sarcoidosis is a condition where inflammatory tissue called granulomas form inside the heart and negatively impact the way it can function. Heart muscles can get severely affected, leading to issues like arrhythmias and scarring. Sarcoidosis is an autoimmune disorder that is characterised by the formation of inflammatory sarcoids in the lungs and other parts of the body. When the heart gets affected too, it can cause various symptoms that mimic a heart attack or palpitations. In India, about 15% of sarcoidosis cases have a cardiac component to them, though the actual numbers may be higher or lower. Studies have shown that sarcoidosis is hard to diagnose in a timely fashion as the symptoms mimic that of tuberculosis.

Cardiac Sarcoid Symptoms

Some common symptoms of cardiac sarcoidosis are as follows

Having to deal with chest pain or tightness
Feeling faint and coughing a lot
Shortness of breath is a common sign
Swelling in the limbs or extremities is common too
Some people report heat palpitations.

Heart Block Causes

Studies have not shown a particular reason for some people getting sarcoidosis while others remain healthy. But, researchers think that it may be due to mutated genes that cause the immune system to work too hard and cause sarcoids or granulomas in the heart, lungs and other parts of the body.

Diagnosis of Cardiac Sarcoidosis

Apart from a physical exam, your doctor may recommend a series of tests that are designed to check how your heart is working and also to visualise for any structural abnormalities. Tests like blood tests, x-rays and EKG or ECG can help your doctor understand how well your heart is functioning. A cardiac MRI for sarcoidosis is a standard test done to see where inflammation and scar tissue formation is present – if the individual comes back repeatedly with pericardial effusion with unknown origins. Rarely, you may be asked to get an endomyocardial biopsy- but these are not highly sensitive. However, a biopsy is a confirmatory gold standard test that is done in some cases.

Other tests are designed to continuously monitor your heart- like a holter monitor, or a heart PET scan. They check for cardiac muscle function, electrical circuitry in your heart and if there is any possibility of an arrhythmia making things worse.

Treatment Of Cardiac Sarcoidosis

Since sarcoidosis is an autoimmune condition, steroids are commonly prescribed to modulate immune response and reduce inflammation. Immunosuppressants may be recommended at times, along with steroids. Antiarrhythmic drugs are given if you have arrhythmias while ACE inhibitors and beta-blockers are prescribed if you have early stage heart failure.

If conventional treatments don’t work, then surgery may be the only resort left to try. Procedures like pacemaker insertion can help your heart beat better. An ICD can be used to improve cardiac rhythm while cardiac ablation or the destruction of the part of the heart’s circuitry or tissues that is causing the arrhythmias is done. The subsequent scar tissue that forms over the site of ablation or injury stops any unwanted symptoms from reoccurring.

Conclusion

Cardiac sarcoidosis is an autoimmune condition that is chronic and can affect cardiac function in the long run. If you notice worrisome symptoms like severe chest pain, an irregular pulse, feel faint or dizzy and have severe heart palpitations, it is better to rush for emergency care- as it can be fatal if not immediately dealt with. If cardiac sarcoidosis is untreated, complications like atrial or ventricular fibrillation can occur. You may also be at high risk of developing heart blocks, heart failure or even sudden cardiac death in extreme cases.

Frequently Asked Questions

What is cardiac sarcoidosis?

Cardiac sarcoidosis is a condition in which clusters of inflammatory cells, called granulomas, form in the heart. It occurs in some people who have sarcoidosis elsewhere in the body. The inflammation can interfere with the heart’s electrical system, muscle function, or both, and may lead to rhythm problems or heart failure.

What are the symptoms of cardiac sarcoidosis?

Symptoms vary and some people have none. Common symptoms include palpitations, dizziness, fainting, chest pain, shortness of breath, fatigue, and swelling of the legs. Cardiac sarcoidosis can also present with sudden rhythm disturbances or a slow heart rate.

How is cardiac sarcoidosis diagnosed?

Diagnosis involves a combination of clinical assessment, heart tests, and imaging. Tests may include an electrocardiogram, heart rhythm monitoring, echocardiography, cardiac MRI, or PET scanning. Blood tests and a review of sarcoidosis in other organs are also used. In some cases, a tissue biopsy is required to confirm the diagnosis.

How is cardiac sarcoidosis treated?

Treatment aims to control inflammation and manage heart complications. Corticosteroids are commonly used to reduce inflammation. Other immune-suppressing medicines may be added. Heart rhythm problems may require medications, a pacemaker, or an implantable cardioverter defibrillator. Heart failure is treated with standard heart medicines.

When should a patient with sarcoidosis see a cardiologist?

A patient with sarcoidosis should see a cardiologist if they have palpitations, fainting, chest pain, breathlessness, or an abnormal heart test. Referral is also advised at diagnosis if there is concern about heart involvement, even without symptoms.