CardioVascular Center

Cardiac Sarcoidosis Program

At Tufts Medical Center, we have a team of physicians with a special interest in the diagnosis and treatment of cardiac sarcoidosis, including an electrophysiologist, a heart failure cardiologist, a pulmonologist, a rheumatologist and a radiologist with FDG/PET expertize. We meet as a team to coordinate the evaluation and treatment of patients with sarcoidosis. For patients who require an intravenous medication such as infliximab, we coordinate with the infusion clinic in the Division of Rheumatology. We participate in multi-center cardiac sarcoidosis research projects and stay at the forefront of advances in cardiac sarcoidosis diagnosis and treatment. 

Sarcoidosis is an inflammatory condition of unknown cause that can affect many areas of the body, including the heart, lungs, lymph nodes, eyes and skin. Sarcoidosis is characterized by the inflammatory cells that clump together forming collections called granulomas. It is thought that these granulomas may be an immune response to a trigger such as an infection or a protein either from self or from the environment, in individuals who are genetically predisposed. Sometimes the condition can affect several people within a family. 

Signs and symptoms of sarcoidosis depend on the organ affected. When the heart is affected, patients may present with:

  • shortness of breath,
  • fluid retention,
  • dizziness,
  • or fainting.

The underlying reason for these symptoms can be weakness of heart pumping function, a block in the electrical conduction of the heart, or a fast electrical rhythm called ventricular tachycardia. Other symptoms experienced by patients with sarcoidosis include cough, wheezing or shortness of breath when the lungs are involved, enlarged lymph nodes or skin rashes, blurred vision, pain, or redness of the eye, numbness or tingling when nerves are involved, or swollen joints.

Diagnosis of sarcoidosis is based partly on recognition of these signs and symptoms and partly on tests of the heart or other affected organ. A myocardial FDG/PET scan is a special nuclear scan that can show active inflammation from sarcoidosis and can be very useful both in diagnosing cardiac sarcoidosis and monitoring response to treatments. Please click here for the instructions when preparing for a myocardial sarcoid FDG/PET scan. Other heart tests that may be of use include an electrocardiogram, an echocardiogram, a heart rhythm monitor, or a cardiac MRI scan. Blood tests are often taken to monitor organ function, but there is no one blood test that can diagnose sarcoidosis. It is often very useful to biopsy either an enlarged lymph node or heart tissue to confirm the diagnosis of sarcoidosis before starting treatment. Because of the multi-organ nature of sarcoidosis, patients with cardiac sarcoidosis are ideally cared for by a team of doctors including heart, lung, rheumatology and imaging specialists. 

In some patients with sarcoidosis, the inflammation resolves without any treatment. In patients with active heart inflammation causing cardiac sarcoidosis symptoms, anti-inflammatory treatment is often recommended. Treatment options can include steroids (such as prednisone), methotrexate, or intravenous infusions such as infliximab (also known as Remicaide®).

What resources are there for patients with Cardiac Sarcoidosis at Tufts Medical Center?

At Tufts Medical Center, we have a team of physicians with a special interest in the diagnosis and treatment of cardiac sarcoidosis, including an electrophysiologist, a heart failure cardiologist, a pulmonologist, a rheumatologist and a radiologist with FDG/PET expertize. We meet as a team to coordinate the evaluation and treatment of patients with sarcoidosis. For patients who require an intravenous medication such as infliximab, we coordinate with the infusion clinic in the Division of Rheumatology. We participate in multi-center cardiac sarcoidosis research projects and stay at the forefront of advances in cardiac sarcoidosis diagnosis and treatment. 

 

Amanda Vest, MBBS, MPH

Amanda Vest, MBBS, MPH

Accepting New Patients

Title(s): Medical Director, Cardiac Transplantation Program; Assistant Professor, Tufts University School of Medicine
Department(s): Medicine, CardioVascular Center, Cardiology
Appt. Phone: 617-636-8068
Fax #: 617-636-6030

Cardiology, heart failure, heart transplantation, mechanical circulatory support

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Ann Garlitski, MD

Ann Garlitski, MD

Accepting New Patients

Title(s): Co-Director, New England Cardiac Arrhythmia Center; Assistant Professor, Tufts University School of Medicine
Department(s): Medicine, CardioVascular Center, Cardiology
Appt. Phone: 617-636-5939
Fax #: 617-636-9115

Cardiac arrhythmias

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Steven C. Vlad, MD, PhD

Steven C. Vlad, MD, PhD

Accepting New Patients

Title(s): Rheumatologist; Assistant Professor, Tufts University School of Medicine
Department(s): Medicine, Rheumatology, Allergy and Immunology
Appt. Phone: 617-636-5990
Fax #: 617-636-2388

General rheumatology, spondyloarthropathies, psoriatic arthritis and anklylosing spondylitis

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Christina Anderlind, MD

Christina Anderlind, MD

Accepting New Patients

Title(s): Pulmonary Attending Physician; ICU Co-Director and Pulmonary Consultant, Lemuel Shattuck Hospital; Assistant Professor, Tufts University School of Medicine
Department(s): Medicine, Pulmonary, Critical Care and Sleep Medicine
Appt. Phone: 617-636-6377
Fax #: 617-636-1649

General pulmonology

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Barry L. Fanburg, MD

Barry L. Fanburg, MD

Title(s): Director, Pulmonary Research; Pulmonary Attending Physician; Professor, Tufts University School of Medicine
Department(s): Medicine, Pulmonary, Critical Care and Sleep Medicine
Appt. Phone: 617-636-6377
Fax #: 617-636-1649

Sarcoidosis, chronic pulmonary disease, emphysema, pulmonary diagnostic problems, cough, asthma, X-ray abnormalities, lymphangioleiomyomatosis (LAM)

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Nayer Nikpoor, MD

Nayer Nikpoor, MD

Title(s): Chief of Nuclear Medicine; Assistant Professor, Tufts University School of Medicine
Department(s): Radiology
Appt. Phone: 617-636-0040
Fax #: 617-636-0041

Nuclear medicine

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To refer a patient and schedule an initial consultation, please call 617-636-8068 and select option 3 for Dr. Vest's office.