Heart failure & cardiomyopathiesResearch article
Diagnostic Approach to Cardiac Sarcoidosis
- Narrative review
- primer
Authors' conclusion
Expert opinion on histologic confirmation in nonurgent presentations is divided, and no diagnostic approach has been prospectively validated.
Study context
- Population
- Patients with suspected or established cardiac sarcoidosis
Main finding
As reported in the abstract
Diagnostic approach to cardiac sarcoidosis
- No single modality achieves both high sensitivity and specificity
- The 4 major consensus documents differ in diagnostic thresholds and can yield discordant diagnoses in the same patient
- Genetic cardiomyopathies account for a meaningful fraction of presumed isolated cardiac sarcoidosis
- Nonurgent presentations: concordant cardiac MRI and 18F-FDG PET abnormalities accepted as sufficient for diagnosis; endomyocardial biopsy when imaging inconclusive or giant cell myocarditis must be excluded
- Advanced imaging should precede permanent device implantation in all de novo presentations
- 5-step pathway integrating advanced imaging, tissue acquisition when it would change management, and genetic evaluation
- 2 clinical contexts: de novo cardiac presentation (unexplained AV block, ventricular arrhythmia or HF without previous sarcoidosis); screening in established extracardiac sarcoidosis
Original publication
Diagnostic Approach to Cardiac Sarcoidosis. Circulation. Published 20 July 2026. doi:10.1161/circulationaha.126.079275
Summarised from the published abstract; every number is checked against it