Histologic diagnostic rate of cardiac sarcoidosis: Evaluation of endomyocardial biopsies

Cardiac Sarcoid: A Clinician's Review on How to Approach the Patient With Cardiac Sarcoid

“…Endomyocardial biopsy is the most specific detection method for CS, but a small tissue sample taken blindly from a myocardium with patchy granulomatous infiltration leads to diagnostic yield of only 20%, 34,35 precluding its routine usage. However, image-guided biopsy should be considered in patients without a prior history of systemic sarcoid who have unexplained arrhythmias or heart failure ( Figure 2).…”

Caso 5: mulher de 50 anos com cardiomiopatia restritiva, insuficiência renal e proteinúria

“…In the development of the case, considering the diagnosis hypotheses, hepatic or myocardial biopsy could have been conducted, since findings of granulomas close up the diagnosis. Nevertheless, false negative results may occur due because the attack is not homogeneous, mainly in heart diseases 16 . What is against the diagnosis of cardiac sarcoidosis in this patient is the presence of septal hyperrefringency in the TTE, as in sarcoidosis, alterations are not specific and may include ventricular aneurism, cavity dilation and wall thickening 17 .…”

Canadian Cardiovascular Society Consensus Conference guidelines on heart failure – 2008 update: Best practices for the transition of care of heart failure patients, and the recognition, investigation and treatment of cardiomyopathies

“…One of the major advances with CMR is the description of an early unusual contrast washout in amyloidosis (139), with subendocardial contrast enhancement associated with nonsuppressible signal of remote myocardium, which may have important therapeutic implications. CMR may increase the sensitivity of myocardial biopsy (140,141) to diagnose the presence or absence of sarcoidosis in the myocardium (142), can further describe the nature of myocardial damage (fibrosis or inflammation) and may help to direct treatment (143). CMR may be helpful in distinguishing between active myocardial disease and clinical remission in systemic lupus erythematosus (144), suspecting the presence of cardiac fibrosis in Churg-Strauss syndrome (a rare form of systemic vasculitis) (145), and detecting early indications of cardiac iron overload in thalassemia patients (146).…”