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Sarcoid Heart Disease: an Update on Diagnosis and Management

  • Heart Failure (HJ Eisen, Section Editor)
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Abstract

Purpose of Review

The purpose of this review is to provide an update on cardiac sarcoidosis (CS) and to discuss the current recommendations and progress in diagnosis and management of this disease. Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Cardiac involvement is seen in at least 25% and is associated with poor prognosis. Manifestations of cardiac sarcoidosis (CS) can vary from presence of silent myocardial granulomas, which may lead to sudden death, to symptomatic conduction abnormalities, ventricular arrhythmias, and heart failure.

Recent Findings

We discuss newer imaging modalities such as cardiac magnetic resonance imaging and positron emission tomography in conjunction with clinical criteria increasingly used for diagnosing and prognosticating patients with CS. Immunosuppression (primarily corticosteroids) is recommended for treatment of CS; however, its efficacy has never been proven in prospective randomized studies. The role of imaging to guide the use of immunotherapy is unknown.

Summary

Cardiac sarcoidosis continues to challenge clinicians due to its protean presentations, lack of diagnostic standards, and data for risk stratification and treatment. There is a need for prospective, randomized controlled trials to understand how best to diagnose and treat cardiac sarcoidosis.

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  1. Division of Cardiology, Department of Medicine, University of Wisconsin, Madison, WI, USA

    Sofia Carolina Masri

  2. Division of Cardiology, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA

    Lavanya Bellumkonda

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Masri, S.C., Bellumkonda, L. Sarcoid Heart Disease: an Update on Diagnosis and Management. Curr Cardiol Rep 22, 177 (2020). https://doi.org/10.1007/s11886-020-01429-4

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