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Pneumologie 2003; 57(12): 752-760
DOI: 10.1055/s-2003-812420
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Kardiale Sarkoidose

Cardiac SarcoidosisW.  Schulte1 , U.  Costabel1 , D.  Kirsten2
  • 1Abteilung Pneumologie/Allergologie, Ruhrlandklinik Essen
  • 2Abteilung Pneumologie, Krankenhaus Großhansdorf.
Prof. Dr. N. Konietzko zum 65. Geburtstag gewidmet.
Further Information

Publication History

Eingang: 15. August 2003

Nach Revision akzeptiert: 20. Oktober 2003

Publication Date:
18 December 2003 (online)

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Zusammenfassung

Die Sarkoidose ist eine Systemerkrankung, bei der die frühzeitigen entzündlichen und unter Therapie rückbildungsfähigen Organveränderungen häufig subklinisch verlaufen. Bei narbigen Residuen ist oft keine Besserung mehr zu erreichen. Ein fortschreitender Funktionsverlust bis zum Organversagen kann auftreten. Der Beteiligung des Herzens kommt dabei eine wesentliche prognostische Bedeutung zu. Ein frühzeitiger Therapiebeginn mit Kortikosteroiden vor Auftreten irreversibler Funktionsstörungen des Herzens geht mit einer exzellenten Prognose einher. Die technischen Entwicklungen in den bildgebenden Verfahren haben zwar die grafische Darstellung von Struktur und Funktion des Herzens deutlich verbessert, dennoch ist bislang kein einzelnes Verfahren in der Früherkennung zuverlässig. Die Kombination verschiedener Verfahren und der klinischen Beschwerden erlaubt jedoch häufig eine frühe Diagnosestellung. Entscheidend ist das „daran denken” und die rechtzeitige Einleitung einer weiterführenden Diagnostik bei entsprechenden Beschwerden. In der spezifischen Therapie fehlen weiterhin Alternativen zur Kortisontherapie. Die symptomatische kardiale Behandlung orientiert sich wesentlich an der Behandlung dilatativer Kardiomyopathien, da in vielen Frage wie z. B. der anti-arrhythmischen Therapie oder der Indikation zur Implantation antitachykarder Schrittmachersysteme keine, eigenständigen verlässlichen Studien zur Herzsarkoidose vorliegen.

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Dr. W. Schulte

Ruhrlandklinik

Tüschener Weg 40

45239 Essen

Email: schulte-adams@t-online.de

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