What cardiologists should know about cardiac sarcoidosis in 2022?

Abstract

Purpose of reviewCardiac sarcoidosis (CS) is a potentially fatal condition when unrecognized or not treated adequately. The purpose of this review is to provide new strategies to increase clinical recognition of CS and to present an updated overview of the immunosuppressive treatments using most recent data published in the last 18 months. Recent findingsCS is an increasingly recognized pathology, and its diagnostic is made 20 times more often in the last two decades. Recent studies have shown that imaging alone usually lacks specificity to distinguish CS from other inflammatory cardiomyopathies. However, imaging can be used to increase significantly diagnostic yield of extracardiac and cardiac biopsy. Recent reviews have also demonstrated that nearly 25% of patients will be refractory to standard treatment with prednisone and that combined treatment with a corticosteroid-sparing agent is often necessary for a period that remains undetermined. SummaryCS is a complex pathology that should always require a biopsy attempt to have a histological proven diagnosis before starting immunosuppressive therapy consisting of corticosteroids with or without a corticosteroid-sparing agent.

Cardiac Sarcoidosis: A Comprehensive Clinical Review

“…Patients with extensive LGE ( 20%) have an even worse outcome than patients with a limited extent of LGE. CMR has a high diagnostic accuracy in detecting CS with a sensitivity of 75–100% and a specificity of 76–85% [ 9 , 10 , 45 , 50 , 55 , 56 , 57 , 58 ]. However the main value of CMR in the diagnostic algorithm of CS is its high ( 90%) negative predictive value.…”