Improving the diagnostic accuracy for detecting cardiac sarcoidosis

Abstract

Cardiac sarcoid is a potentially fatal condition that presents with a wide range of clinical manifestations including conduction abnormalities, tachyarrhythmias, congestive heart failure, cardiomyopathy and sudden cardiac death. Small observational registries and non-comparative studies have described clinical evidence of cardiac involvement in 5% of patients with systemic sarcoid, yet autopsy studies suggest prevalence as high as 79%. This suggests that cardiac sarcoidosis (CS) is underdiagnosed in everyday clinical practice. The scarcity of data and lack of consensus on the most appropriate methods for detecting, monitoring and treating CS presents a significant diagnostic and therapeutic challenge. This review explores the potential impact of novel strategies, including multimodality imaging, on the diagnostic accuracy for detecting CS and treatment.

Diagnostic accuracy and prognostic value of simultaneous hybrid 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging in cardiac sarcoidosis

“…Sarcoidosis is a multi-system inflammatory disorder characterised by non-caseating granulomata (1)(2)(3). Clinical studies suggest that only 5% of patients with systemic sarcoidosis have overt cardiac involvement (4), yet autopsy series report cardiac involvement in up to 50% of cases with fatal sarcoidosis (2,5), suggesting that cardiac sarcoidosis (CS) is frequently underdiagnosed with potentially lifethreatening consequences.…”

Heart Failure and Cardiomyopathies: CT and MR from Basics to Advanced Imaging

“…Similarly, CMR may also be quite effective for detecting sarcoidosis through granulomatous identification with LGE, more specific in subepicardial anteroseptal and inferolateral basal wall; however, diagnosis is difficult as its diverse features are often superimposable to other acute inflammatory and non-inflammatory injuries, and novel hybrid PET-CMR may help identify active granulomatous lesions with high sensitivity [ 268 , 269 ].…”

Causes systémiques ou originales de douleurs thoraciques

“…Un réflexe encore plus vital serait toutefois de vérifier l'absence d'atteintes myocardiques, car bien que rarement à l'origine de douleurs thoraciques, celles-ci peuvent dominer, voire régler, le pronostic des sarcoïdoses, et semblent extrême-ment fréquentes à l'autopsie (jusqu'à 80 % des patients), même si 5 % seulement sont dépistées cliniquement ou sur les examens de routine [59]. Le risque de cette localisation cardiaque est la mort subite par troubles du rythme ou de la conduction.…”