Sarcoidosis is a disease characterized by the growth of small inflammatory cell clusters (granulomas) in various parts of the body. This condition most commonly affects the lungs, lymph nodes, eyes, skin, and heart.

The exact cause of sarcoidosis is still unknown, but it is believed to be related to the following factors:

• Genetics
• Exposure to non-infectious agents, such as dust or chemicals
• Infections, including viruses, bacteria, and fungi

In addition to the aforementioned factors, there are several conditions that can increase the risk of someone developing sarcoidosis, such as:

• Being female
• Age between 20 and 65 years
• Having a family history of sarcoidosis
• Having a history of lymphoma

The symptoms of sarcoidosis can appear gradually with varying patterns, depending on the affected organs. In some cases, there are symptoms that appear only temporarily and then disappear. There are also symptoms that can persist for years (chronic) or may not manifest at all.

Sudden-onset sarcoidosis commonly presents a set of characteristic symptoms known as Lofgren's syndrome. These symptoms include fever, swollen lymph nodes, joint pain and swelling, as well as reddish nodules on the skin (erythema nodosum). The symptoms also depend on the affected organ, such as in the case of cardiac involvement.

Individuals with cardiac sarcoidosis may experience fatigue, chest pain, shortness of breath, heart rhythm disturbances (arrhythmia), palpitations, fluid retention in the body (edema), and even sudden death.

Management of Cardiac Sarcoidosis After a diagnosis of sarcoidosis is made, there are usually further examinations to detect which organs are affected. The treatment depends on the severity of the condition and may include:

• Medications to reduce inflammation or restore the heart's rhythm
• Implantable cardioverter defibrillator (ICD) placement for severe heart rhythm disturbances or arrhythmias. This device is connected to the heart's blood vessels and sends electrical impulses to restore normal heart rhythm when necessary.
• Catheter ablation to address heart rhythm disturbances by delivering energy to the heart through a catheter inserted into blood vessels.
• Left ventricular assist device (LVAD) placement, which functions like a pump connected to a battery to assist the heart in pumping blood.
• Heart transplantation for severe cases of sarcoidosis.

Complications of Cardiac Sarcoidosis involve disturbances in the heart's electrical system, which can lead to complications such as arrhythmias and heart failure. Arrhythmia is a heart rhythm disorder that occurs when electrical impulses from the upper chambers of the heart cannot reach the lower chambers, resulting in an irregular heartbeat.

Heart failure, on the other hand, is a heart condition related to arrhythmia. It occurs when the heart is too weak to pump blood effectively, even though the blood carrying oxygen and nutrients is needed by all organs in the body.

Symptoms of arrhythmia include easy fatigue, dizziness, and fainting. Symptoms of heart failure include shortness of breath, fatigue, swelling in the legs, and a dry cough.

Prevention Due to the uncertain cause of cardiac sarcoidosis, prevention efforts present challenges. However, adopting a healthy lifestyle to maintain heart health is one of the recommended ways, such as:

• Engaging in an active lifestyle
• Regular exercise
• Practicing a balanced diet
• Managing stress
• Avoiding smoking

Additionally, it is essential to avoid materials that are believed to trigger cardiac sarcoidosis. Leading a healthy life is the best way to prevent or at least minimize the risk of various diseases.

Author: Dr. Fatimah Bebi (Medical Laboratory Services Doctor at PRAMITA Clinic Branch, Jl. Diponegoro No. 37, Medan).