Top Things to Know: Diagnosis and Management of Cardiac Sarcoidosis

Published: April 18, 2024

Prepared by Prepared by: Paul St. Laurent, DNP, RN, Vice President, Science and Medicine, AHA

Cardiac sarcoidosis is an infiltrative cardiomyopathy resulting from granulomatous inflammation of the myocardium.
This statement provides a comprehensive overview of the diagnosis, treatment options, and outcomes of cardiac sarcoidosis, including the challenges in diagnosing and the importance of a multidisciplinary approach.
Diagnosis of cardiac sarcoidosis is challenging due to diverse and nonspecific presentations, and definitive histologic confirmation is often not possible.
Treatment for cardiac sarcoidosis is initiated in individuals with clinical manifestations and active inflammation, with corticosteroids as first-line treatment.
Diagnostic modalities for cardiac sarcoidosis include electrocardiography, echocardiography, cardiac magnetic resonance imaging (CMR), and cardiac positron emission tomography (PET).
CMR is a high-spatial resolution technique used to localize and quantify areas of late gadolinium enhancement (LGE) as a marker of myocardial involvement from sarcoidosis.
Fluorodeoxyglucose (FDG)-PET is performed in conjunction with CMR to assess disease activity and monitor treatment response.
Diagnostic criteria for cardiac sarcoidosis include histologic confirmation, clinical diagnosis, and imaging findings consistent with cardiac sarcoidosis.
Treatment of cardiac sarcoidosis involves immunomodulating agents such as corticosteroids, methotrexate, mycophenolate, azathioprine, infliximab, adalimumab, and rituximab.
Risk stratification for sudden cardiac death in cardiac sarcoidosis includes evaluation of conduction system abnormalities, atrial arrhythmias, and ventricular arrhythmias.

View the summary for Diagnosis and Management of Cardiac Sarcoidosis

Citation

Cheng RK, Kittleson MM, Beavers CJ, Birnie DH, Blankstein R, Bravo PE, Gilotra NA, Judson MA, Patton KK, Rose-Bovino L; on behalf of the American Heart Association Heart Failure and Transplantation Committee of the Council on Clinical Cardiology, and Council on Cardiovascular and Stroke Nursing. Diagnosis and managementof cardiac sarcoidosis: a scientific statement from the American Heart Association. Circulation. Published online April 18, 2024. doi: 10.1161/CIR.0000000000001240