Performance of diagnostic criteria in patients clinically judged to have cardiac sarcoidosis: Is it time to regroup?

Neto, Miguel José Francisco; Jellis, Christine; Hachamovitch, Rory; Wimer, A.; Highland, Kristin B.; Sahoo, Debasis; Khabbaza, Joseph; Pande, Aman; Bindra, Akhil; Southern, Brian D.; Parambil, Joseph G.; Callahan, Thomas; Joyce, Emer; Culver, Daniel A.

doi:10.1016/j.ahj.2020.02.008

Cited by 30 publications

(26 citation statements)

References 13 publications

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“…A recent study compared three main diagnostic criteria with a conclusion of low concordance between the Japanese Circulation Society (JCS) criteria and the other two criteria (WASOG and HRS), raising questions about the specificity of the diagnosis of sarcoidosis in the absence of a confirmatory biopsy. Compared with the JMHW criteria, HRS criteria are thought to have greater sensitivity because these criteria include cardiac PET, PET, and MRI, as well as responsiveness to corticosteroid therapy [ 2 , 4 - 11 ].…”

Section: Discussionmentioning

confidence: 99%

Catastrophic Events of Cardiac Sarcoidosis: A Case Report

Riasat¹,

Khan²,

Ehtesham³

et al. 2022

Cureus

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Cardiac sarcoidosis (CS) can be silent in most patients with extrapulmonary sarcoidosis. Atrioventricular (AV) block is the most common clinical presentation, but it can also present as fatal ventricular arrhythmias and sudden cardiac death. Endomyocardial biopsy is the gold standard; however, it is not sensitive since CS can involve the myocardium in a patchy distribution. Our case depicts a female who presented with syncope; however, her hospital course was complicated by multiple cardiac arrests. Her initial laboratory tests, including an autoimmune workup, were unremarkable. Cardiac magnetic resonance and fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging revealed intramyocardial delayed enhancement of the basal anteroseptal (non-ischemic distribution) and patchy foci of increased uptake in the anteroseptal and inferior myocardial region, respectively. The patient was started on intravenous methylprednisolone, and her condition slowly improved. Post-discharge, the patient followed in the outpatient clinic with a repeat FDG-PET scan revealing resolution of myocardial FDG uptake. She also underwent bronchoscopy with lymph node biopsy showing granulomas and endobronchial biopsy confirming pulmonary sarcoidosis.

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Section: Discussionmentioning

confidence: 99%

Catastrophic Events of Cardiac Sarcoidosis: A Case Report

Riasat¹,

Khan²,

Ehtesham³

et al. 2022

Cureus

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“…However, the diagnosis CS without histologic evidence came into question in a study that found low concordance between JCS and other major diagnostic tools for CS. [9]…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of cardiac sarcoidosis based on clinical suspicion and advanced cardiac imaging: A case report

et al. 2022

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Introduction: Confirming the diagnosis of cardiac sarcoidosis (CS) is a challenging task as we often do not count with histopathologic evidence. However, prompt initiation of treatment is sometimes necessary, and advanced cardiac imaging along with key clinical findings can play a crucial role in the diagnostic workup. Patient concerns: A 77-year-old male with a history of heart failure presented with chest pain and shortness of breath. He was found to have an acute drop in left ventricular ejection fraction associated with frequent premature ventricular contractions and nonsustained ventricular tachycardia. Coronary angiogram was negative for acute coronary syndrome. Advanced cardiac imaging with cardiac magnetic resonance raised suspicion of CS, and steroids were started empirically. Endomyocardial biopsy was attempted but was not successful. Diagnosis: The patient’s presentation was highly suggestive of cardiac sarcoidosis. Interventions: Corticosteroids, diuresis, guideline-directed medical therapy for heart failure. Outcomes: The patient’s symptoms and ventricular arrhythmias improved on steroids. Subsequent FDG-PET revealed increased uptake in a pattern consistent with CS. Conclusion: This clinical scenario highlights the importance of advanced cardiac imaging and clinical findings for the diagnosis of CS and exposes the practical need for a standardized, noninvasive strategy to the diagnosis of CS.

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“…There are three available algorithms, including the new version of the Japanese Ministry of Health and Welfare (2016) [ 37 ], which help in assessing the diagnosis probability of cardiac sarcoidosis [ 17 , 38 ]. However, when their conclusions disagree, this calls for a multidisciplinary discussion with a cardiologist and specialists in cardiac imaging for a final diagnosis (including ruling out cardiac sarcoidosis and considering an alternative diagnosis) and treatment strategy adapted to every patient [ 39 ]. Differential diagnoses include coronary diseases, giant cell myocarditis, arrhythmogenic right ventricular dysplasia, and granulomatosis with polyangiitis [ 3 ].…”

Section: Diagnosis Of Extrapulmonary Organ Sarcoidosismentioning

confidence: 99%

How to Tackle the Diagnosis and Treatment in the Diverse Scenarios of Extrapulmonary Sarcoidosis

et al. 2021

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Extrapulmonary sarcoidosis occurs in 30-50% of cases of sarcoidosis, most often in association with pulmonary involvement, and virtually any organ can be involved. Its incidence depends according to the organs considered, clinical phenotype, and history of sarcoidosis, but also on epidemiological factors like age, sex, geographic ancestry, and socio-professional factors. The presentation, symptomatology, organ dysfunction, severity, and lethal risk vary from and to patient even at the level of the same organ. The presentation may be specific or not, and its occurrence is at variable times in the history of sarcoidosis from initial to delayed. There are

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Performance of diagnostic criteria in patients clinically judged to have cardiac sarcoidosis: Is it time to regroup?

Cited by 30 publications

References 13 publications

Catastrophic Events of Cardiac Sarcoidosis: A Case Report

Catastrophic Events of Cardiac Sarcoidosis: A Case Report

Successful treatment of cardiac sarcoidosis based on clinical suspicion and advanced cardiac imaging: A case report

How to Tackle the Diagnosis and Treatment in the Diverse Scenarios of Extrapulmonary Sarcoidosis

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