Sarcoidosis presenting as heart disease.

It is unusual for sarcoidosis to present with isolated cardiac involvement. We report 3 patients in whom conduction disturbances preceded other clinical or radiographic evidence of sarcoidosis, in 2 cases by several years. The literature of sarcoidosis manifesting solely with cardiac disease is reviewed. Our report is intended to emphasize consideration of sarcoidosis in the diagnostic evaluation of cardiac disease without another obvious cause, particularly in young patients with conduction disturbances, arrhythmias, or cardiomyopathy. We suggest diagnostic strategies and a therapeutic approach.