Guidelines for Diagnosis of Cardiac Sarcoidosis from Japanese Ministry of Health and Welfare
| Histologic diagnosis group |
|---|
| Cardiac sarcoidosis is diagnosed when histologic analysis of operative or endomyocardial biopsy specimens demonstrates epithelioid granuloma without caseating granuloma |
| Clinical diagnosis group |
| In patients with histologic diagnosis of extracardiac sarcoidosis, cardiac sarcoidosis is diagnosed when item (a) and 1 or more of items (b–e) are present |
| (a) Complete right bundle branch block, left-axis deviation, atrioventricular block, ventricular tachycardia, premature ventricular contraction (>grade 2 in Lown’s classification), or abnormal Q or ST–T change on electrocardiogram or Holter electrocardiogram |
| (b) Abnormal wall motion, regional wall thinning or thickening, or dilatation of LV on echocardiogram |
| (c) Perfusion defect in 201Tl myocardial scintigram or abnormal accumulation in 67Ga-citrate or 99mTc-pyrophosphate myocardial scintigram |
| (d) Abnormal intracardiac pressure, low cardiac output, or abnormal wall motion or depressed ejection fraction of LV |
| (e) Interstitial fibrosis or cellular infiltration over moderate grade in endomyocardial biopsy even if findings are nonspecific |