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Introduction: Cardiac involvement affects clinically around 5% of patients with sarcoidosis. There is limited information on the timing of cardiac sarcoidosis. Aim: To determine the timing of cardiac involvement in patients with sarcoidosis. Methods: In a cross-sectional study, we enrolled all cardiac sarcoidosis subjects registered in the University of Miami Sarcoidosis Program registry from Jan. 2016 to Jan. 2017. These patients had annual assessment of cardiac involvement with screening ECG, followed by imaging studies if required. Cardiac sarcoidosis was grouped as at least probable, or possible per World Association for Sarcoidosis and other Granulomatous Disorders guidelines. The Kaplan-Meir estimate curve was used to determine the cumulative probability of diagnosing cardiac involvement. Results: Among 85 subjects in our registry, 10(11.7%) subjects met the criteria for at least probable cardiac sarcoidosis. They had age mean (SD) 56.6 (8.1), and sarcoidosis diagnosis age of 49.6 (11.3) years. Cardiac sarcoidosis was diagnosed at a mean age of 50.6 (8.7) years. In 8(80%) subjects, cardiac sarcoidosis was the presenting feature2(20%) of subjects were diagnosed 5 or more years after sarcoidosis was diagnosed. (Figure 1). Conclusion: Our pilot study suggests that cardiac involvement in sarcoidosis usually occurs in the early phase of disease and the risk decreases over time. Therefore, we recommend that screening for cardiac sarcoidosis should be a part of the initial evaluation of every patient with sarcoidosis.

This is the case of a 33-year-old man with Behçet’s disease who presented with recurrent haemoptysis and a rapidly expanding right pulmonary artery pseudoaneurysm. Due to the significant risk of major bleeding and death, he was promptly treated with an Amplatzer vascular plug.