Guidelines for Diagnosis of Cardiac Sarcoidosis from Japanese Ministry of Health and Welfare
| Criterion for diagnosis of cardiac sarcoidosis |
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| 1: Histologic diagnosis group |
| Cardiac sarcoidosis is diagnosed when histologic analysis of operative or endomyocardial biopsy specimens demonstrates epithelioid granuloma without caseating granuloma. |
| 2: Clinical diagnosis group |
| In patients with histologic diagnosis of extracardiac sarcoidosis, cardiac sarcoidosis is diagnosed when item “a” and one or more of items “b-e” are present. |
| a. Complete right bundle branch block, left-axis deviation, atrioventricular block, ventricular tachycardia, premature ventricular contraction (more than second grade of Lown’s classification), or abnormal Q or ST-T change on electrocardiogram or ambulatory electrocardiogram |
| b. Abnormal wall motion, regional wall thinning or thickening, or dilatation of left ventricle on echocardiogram |
| c. Perfusion defect in 201T1 myocardial scintigraphy or abnormal accumulation in 67Ga-citrate or 99mTc-pyrophosphate myocardial scintigraphy |
| d. Abnormal intracardiac pressure, low cardiac output, or abnormal wall motion or depressed ejection fraction of left ventricle |
| e. Interstitial fibrosis or cellular infiltration over moderate grade in endomyocardial biopsy even if findings are nonspecific |