Cardiac Sarcoidosis?

Three years ago when I was 24, had brief episode of a-fib.
Cardioverted and it went away. This a-fib was not due to any drug/alcohol use.

Within the last year, lost vision slightly in one eye.
Have minor cough for the last 2/3 years.
For years Tonsils red, swollen and asymmetrical
Out of breath during hard exercise, almost passing out.
Just found I have sleep apnea.
Have resting heart rate of between 100-110. BP 145/92

Recently started having skipped beats, and turned into a-fib. After 2 days converted to normal rhythm and started having horrible tachycardias. Had Echo and stress test. Had more tachy and after treadmill I went into another one. Doc saw it for just a second but it terminated before he could record it. Said it was SVT.
On 75mg Flecanide 2/d and 240mg cardizem.
Tests say, echo said EF 40%, radiological was 54%.
Blood tests normal, but high calcium.
One doc said arrhythmias were beating up my heart and should do ablation.
Another doc said that it was unlikely the few episodes of tachy would damage heart like that. He said probably a virus that would go away.
Even on meds, if I try to exercise, get skipped beats.

Neither doc seemed concerned at all.

Thinking could be Cardiac Sarcoidosis.
Matches my unexplained symptoms.

1. It likely that a few short episodes of A-fib, SVT and skipped beats could damage heart to the point that my EF is lowered?
2. Mother had Hodgkin’s Lymphoma said she had granules in one of her lymph nodes they removed. Could this be related to sarcoidosis, or are granules common in Hodgkins? (Hereditary?)
3. How certain can a doctor be that this is SVT, rather than dangerous VT? These episodes were never recorded and studied. Only saw screen for 10 sec.
4. Could stress be causing the arrhythmias to get worse?
5.Could recommend Dr. in Utah knowledgeable about cardiac sarcoisosis and might be able to diagnose/rule out?
6.How hard is it to diagnose cardiomyopathy as hypertonic, dilated or restricted?

[Michael J. McWilliams, M.D.]

1.  It is not likely that short bursts of tachycardia would significantly lower your EF unless they were very frequent, almost incessant.

2. No sure how to answer this one.  Granulomas are common in sarcoidosis.  If she had Hodgkins, it was probably related to her hodkins.  This is not typcially hereditary in a direct way.

3. SVTs and VTs look different on EKGs.  Some types of SVTs can be confused for VT and vice versa, but I would need to see the strips to comment if this is possible.

4. Stress can affect arrhythmias and can increase them.

5. I don't know any doctors that work with hearts in Utah.  Your best bet is to go to an academic center.  Teaching  hospitals are very good at cases like this (university of utah, BYU, etc)

6. In general it is not very hard.  a good echocardiogram makes the diagnosis pretty clear.  There can be ambiguity to borderline cases.

I hope this helps.