Diagnostic Approach and Management of Cardiac Sarcoidosis

Purpose of ReviewSarcoidosis is a systemic inflammatory disorder affecting multiple organ systems, with heterogenous clinical sequelae. Cardiac sarcoidosis (CS) is an underrecognized manifestation with significant clinical implications. Advances in cardiac imaging and new therapeutic options are rapidly changing the clinical approach to CS.Recent FindingsCardiac magnetic resonance imaging (CMR), (18)Fluorodeoxyglucose positron emission tomography (FDG-PET), and hybrid CMR/FDG-PET imaging have emerged as powerful diagnostic and prognostic tools for CS and provide a means to monitor disease activity. Therapeutic options are similarly changing, with steroid-sparing agents and biologic therapy showing clinical promise, though ongoing clinical trials will potentially provide necessary evidence to definitively guide treatment.In this review, we critically evaluate a variety of diagnostic and therapeutic options for CS. Additionally, we propose algorithms for the diagnostic evaluation and treatment of CS, which incorporate current guidelines as well as recent advances in CS.