The sudden onset of massive tricuspid insufficiency in a patient with ocular and pulmonary sarcoïdosis diagnosed fifteen years earlier exemplifies the possible occurrence of sarcoid heart disease, an entity often misdiagnosed or overlooked. After excluding pericardial effusion and rhythm disturbances we point out the specific characteristics of endomyocardial involvement and discuss the mechanisms of valvular dysfunction. In this particular localization, the possibly deleterious effect of steroid therapy is mentioned.

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