Cardiac Sarcoidosis
Cardiac Sarcoidosis is an infiltrative inflammatory disease that can silently damage the conduction system and myocardium, leading to heart block, ventricular arrhythmias, heart failure, or sudden death. This session focuses on recognizing clinical red flags—unexplained AV block in younger adults, idiopathic ventricular tachycardia, or cardiomyopathy with patchy involvement—and building a structured diagnostic approach. Participants will explore how to combine clinical history, ECG, echocardiography, cardiac MRI, PET imaging, and tissue diagnosis when feasible. The aim is to help clinicians suspect and detect cardiac sarcoid early enough to prevent irreversible damage and life-threatening events.
Because presentations are diverse, many clinicians search for a cardiology conference to clarify diagnostic pathways and treatment strategies. This session reviews typical imaging patterns on MRI and FDG-PET, the relationship between cardiac and extracardiac sarcoidosis, and the role of biopsy from lymph nodes, lung, or endomyocardial tissue. Attendees will learn how to distinguish active inflammation from established scar, and how this distinction guides decisions about immunosuppression, device implantation, and ongoing surveillance. Case-based discussions highlight scenarios such as recurrent syncope, sustained VT, or rapidly progressive AV block in patients with known or suspected sarcoid.
A major theme is comprehensive management of granulomatous myocarditis within multidisciplinary teams. Participants will examine steroid-based regimens, steroid-sparing agents, and strategies for monitoring treatment response using symptoms, biomarkers, and serial imaging. The session addresses when to recommend ICD implantation for primary or secondary prevention, how to manage patients with CRT needs, and how to approach ablation in the context of active or burned-out disease. Collaboration with pulmonology, rheumatology, and radiology is emphasized to ensure consistent care across organ systems.
The session also tackles long-term follow-up and patient counselling. Attendees will discuss how to communicate prognosis, address concerns about immunosuppressive side effects, and set expectations for monitoring frequency. By the end, clinicians will have a structured framework for recognizing cardiac sarcoidosis, selecting appropriate investigations, and delivering individualized therapy that balances inflammation control, arrhythmia prevention, and quality of life.
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Recognizing Suspicious Presentations
- Identifying unexplained AV block, ventricular tachycardia, or nonischemic cardiomyopathy in younger patients.
- Linking systemic sarcoidosis, pulmonary findings, or uveitis with possible cardiac involvement.
Imaging and Tissue Diagnosis Strategies
- Using MRI and FDG-PET to distinguish active inflammation from fibrotic scar.
- Deciding when to pursue extracardiac or endomyocardial biopsy to confirm granulomatous disease.
Risk Stratification and Device Planning
- Assessing arrhythmia burden, conduction disease, and ventricular function to guide ICD decisions.
- Considering CRT or conduction system pacing in patients with dyssynchrony or pacing dependence.
Immunosuppression and Monitoring
- Designing steroid and steroid-sparing regimens tailored to disease severity and comorbidities.
- Tracking clinical status and imaging changes to refine treatment intensity over time.
Clinical and Program Benefits in Cardiac Sarcoidosis
Earlier Detection of High-Risk Patients
Systematic pathways for cardiac sarcoid lead to earlier diagnosis in those with conduction disease or ventricular arrhythmias.
Better Alignment of Imaging and Therapy
Coordinated MRI and FDG-PET protocols help distinguish active inflammation from scar so treatment is appropriately targeted.
More Appropriate Use of Immunosuppression
Structured regimens and monitoring reduce both under-treatment of inflammation and unnecessary steroid exposure.
Safer Arrhythmia and Device Management
Clear criteria for ICD and CRT implantation lower sudden death risk while avoiding unnecessary procedures.
Improved Multidisciplinary Coordination
Standardized collaboration among cardiology, rheumatology, pulmonology, and radiology streamlines complex care.
Stronger Long-Term Outcome Tracking
Dedicated follow-up and registries clarify prognosis and refine future management strategies for cardiac sarcoidosis.
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