Sarcoidosis cardíaca. Estado del arte

Edison Muñoz-Ortiz, Edwin Arévalo-Guerrero, Pedro Abad, Juan Manuel Senior

Resumen


La sarcoidosis es una enfermedad infrecuente de etiología desconocida, descrita hace más de 80 años, y caracterizada por un trastorno multisistémico con presencia de lesiones granulomatosas no caseificantes. El compromiso cardíaco es variable según la región estudiada, pero en general se acepta que 5 % de los pacientes con sarcoidosis sistémica tienen infiltración cardíaca con evidencia clínica; sin embargo, estudios de autopsia indican que hasta 20 % a 30 % de los pacientes con sarcoidosis tienen afectación miocárdica. 

Se han propuesto factores ambientales, ocupacionales e infecciosos como los disparadores del proceso en individuos con predisposición genética. La sarcoidosis cardíaca puede tener un amplio espectro de presentaciones e incluso puede ser asintomática; las manifestaciones más frecuentes son por falla cardíaca, alteraciones del ritmo cardíaco y arritmias ventriculares letales. El tratamiento incluye medicamentos para la falla cardíaca, esteroides e inmunosupresores, tratamiento de las arritmias letales con ablación y/o cardiodesfibrilador implantable y, en casos avanzados, el trasplante cardíaco. 


Palabras clave


Arritmias; Insuficiencia cardíaca; Sarcoidosis

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Referencias


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DOI: https://doi.org/10.17533/udea.iatreia.v29n4a07 Resumen : 619 PDF : 659

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