Table 4.

Guidelines for Diagnosing Cardiac Sarcoidosis (from the Japanese Ministry of Health and Welfare)

1. Histologic diagnosis group

Cardiac sarcoidosis is confirmed when histologic analysis of operative or endomyocardial biopsy specimens demonstrates epithelioid granuloma without caseating granuloma

2. Clinical diagnosis group

In patients with a histologic diagnosis of extracardiac sarcoidosis, cardiac sarcoidosis is suspected when item (a) and one or more of items (b) though (e) are present

(a) Complete right bundle branch block, left axis deviation, atrioventricular block, ventricular tachycardia, premature ventricular contraction, or abnormal Q or ST‐T change on the ECG or ambulatory ECG

(b) Abnormal wall motion, regional wall thinning, or dilatation of the left ventricle

(c) Perfusion defect by thallium‐201 myocardial scintigraphy or abnormal accumulation by gallium‐67 or technetium‐99m myocardial scintigraphy

(d) Abnormal intracardiac pressure, low cardiac output, or abnormal wall motion or depressed ejection fraction of the left ventricle

(e) Interstitial fibrosis or cellular infiltration over moderate grade even if the findings are nonspecific