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Clinical Features and Diagnosis of Cardiac Sarcoidosis

Claudio Tana1, Cesare Mantini2, Iginio Donatiello3

  • 1COVID-19 Medicine Unit and Geriatrics Clinic, SS Annunziata Hospital of Chieti, 66100 Chieti, Italy.

Journal of Clinical Medicine
|June 2, 2021
PubMed

Insights

Cardiac sarcoidosis (CS) is a serious manifestation of systemic sarcoidosis. Advanced imaging like CMR and 18F-FDG PET offers a cost-effective diagnostic approach, potentially replacing invasive biopsies.

Area of Science:

  • Cardiology
  • Pulmonology
  • Immunology

Background:

  • Cardiac sarcoidosis (CS) is an uncommon yet severe manifestation of systemic sarcoidosis (SA).
  • While lungs are typically affected, CS can impact up to 25% of SA patients, often leading to poor prognosis and mortality, especially in African American individuals.
  • Non-specific symptoms of CS can mimic other cardiac disorders, complicating diagnosis.

Purpose of the Study:

  • To summarize the clinical features and diagnostic imaging findings of cardiac sarcoidosis.
  • To highlight the role of cardiovascular magnetic resonance (CMR) and 18-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in diagnosing CS.
  • To evaluate the cost-benefit ratio of imaging modalities for CS diagnosis.

Main Methods:

  • This narrative review synthesizes current literature on cardiac sarcoidosis.
  • Focuses on clinical presentations and diagnostic imaging techniques, specifically CMR and 18F-FDG PET.
  • Compares the diagnostic utility and risks of imaging versus endomyocardial biopsy.

Main Results:

  • Cardiac involvement in sarcoidosis is associated with significant morbidity and mortality.
  • CMR and 18F-FDG PET provide valuable insights into CS diagnosis with a favorable cost-benefit ratio.
  • Imaging techniques can accurately detect cardiac involvement, guiding treatment decisions.

Conclusions:

  • Cardiac sarcoidosis diagnosis is challenging due to non-specific symptoms.
  • CMR and 18F-FDG PET are crucial non-invasive tools for diagnosing CS.
  • Advanced imaging can reduce the need for invasive procedures like endomyocardial biopsy, improving patient safety.

Keywords:
18F-FDG PETbiopsycardiac sarcoidosisimagingmagnetic resonance imaging

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