Cardiac sarcoidosis.

Area of Science:

• Cardiology
• Immunology
• Pulmonology

Background:

• Cardiac sarcoidosis (CS) diagnosis is difficult due to patchy myocardial involvement and low endomyocardial biopsy yield.
• Current guidelines often require histological confirmation, hindering diagnosis, especially for isolated CS.
• Treatment decisions for CS currently rely on expert consensus and accumulated experience, lacking large-scale study guidance.

Purpose of the Study:

• To review current diagnostic criteria and modalities for cardiac sarcoidosis.
• To summarize recommended treatment strategies for cardiac sarcoidosis.
• To provide expert opinions on tailoring diagnostic and treatment plans for CS.

Main Methods:

• Literature review of diagnostic criteria and imaging modalities for CS.
• Analysis of current treatment recommendations and expert consensus for CS.
• Synthesis of expert opinions on managing CS.

Main Results:

• Endomyocardial biopsy has a low diagnostic yield in CS.
• Advanced imaging like cardiac MRI and 18-FDG PET have improved CS diagnosis.
• Treatment of CS remains challenging due to limited large-scale data and varying expert opinions.

Conclusions:

• While imaging has improved CS diagnosis, histological confirmation remains a challenge.
• New immunosuppressants are being used, but their efficacy in CS needs further investigation.
• Personalized approaches to diagnosis and treatment are crucial for managing cardiac sarcoidosis effectively.