Pathophysiological Gaps, Diagnostic Challenges, and Uncertainties in Cardiac Sarcoidosis

Cardiac sarcoidosis can mimic any cardiomyopathy in different stages. Noncaseating granulomatous inflammation can be missed, because of the nonhomogeneous distribution in the heart. The current diagnostic criteria show discrepancies and are partly nonspecific and insensitive. Besides the diagnostic pitfalls, there are controversies in the understanding of the causes, genetic and environmental background, and the natural evolution of the disease. Here, we review the current pathophysiological aspects and gaps that are relevant for future cardiac sarcoidosis diagnostics and research.

Automated summary

Cardiac sarcoidosis can mimic any cardiomyopathy due to nonhomogeneous distribution of inflammation in the heart. The current diagnostic criteria are inconsistent and partly nonspecific and insensitive. In addition to the diagnostic challenges, there are controversies surrounding the causes, genetic and environmental background, and natural evolution of the disease. This review highlights the current understanding and research gaps in the pathophysiology of cardiac sarcoidosis that will be relevant for future diagnostics and research.