Cardiac sarcoidosis: case series at a tertiary care centre in the brazilian northeast

Abstract

Cardiac sarcoidosis is a manifestation of systemic sarcoidosis, an inflammatory disease of unknown etiology characterized by non-caseating granulomas. Clinical presentation ranges from asymptomatic to sudden cardiac death, the common symptoms are dyspnea, palpitations, and fatigue, and signs such as advanced atrioventricular block, heart failure with reduced ejection fraction, and sustained ventricular tachycardia. Diagnosis remains challenging without a single definitive test, relying instead on a combination of clinical criteria, imaging (cardiac MRI and 18F-FDG PET) and endomyocardial biopsy. The diagnosis can be classified as definitive, highly probable, probable and possible. Documenting a case series is essential to improve understanding, promote early suspicion, and enhance outcomes in this rare and often late-diagnosed condition. Cardiac sarcoidosis is a rare, often underdiagnosed inflammatory condition. The scarcity of national and regional data makes it difficult to understand its epidemiological and prognostic characteristics. This was an observational, retrospective, and descriptive case series study. Data were collected through a review of electronic medical records. Seven cases of cardiac sarcoidosis were reported, classified as highly probable, probable and possible. We have included a table (Table 1) in the images detailing the characteristics of the described cases, which presents information on sex, age, most frequent symptoms, electrocardiogram findings, Time between symptom onset and diagnosis,.diagnostic methods, diagnostic classification, presence of extracardiac sarcoidosis, and treatment. Figure 2 is a set of four charts comparing the frequency of the most common signs and symptoms among the cases (A), the presence of extracardiac sarcoidosis (B), diagnostic classification (C), and treatment modality (D). This case series highlights the heterogeneous clinical presentation of cardiac sarcoidosis, the role of multimodality imaging in diagnosis, and available treatment strategies. These findings reinforce the need for a high index of suspicion to achieve early diagnosis, thereby improving the prognosis of this highly multimorbid disease.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.