Analysis of Diagnostic and Therapeutic Strategies for Cardiac Sarcoidosis:A Retrospective Case Series Study

XUE Yanan; LI Ran; WU Han; KANG Lina

doi:10.3639/j.issn.2095-3097.2025.06.015

Abstract：Objective Given the diagnostic challenges and lack of specific treatments for cardiac sarcoid-osis(CS),analyzing its diagnostic and therapeutic processes aims to provide reference experience for clinicians.Methods We retrospectively analyzed demographic data,clinical presentations,and diagnostic strategies in CS patients diag-nosed and admitted to the cardiology department of Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School between November 2022 and December 2023.Results Five CS patients were included(3 males,2 females;age range 50-68 years,mean 59.20±7.68).All five presented with arrhythmia as the primary cardiovascular manifestation:palpitations were the initial symptom in 3 cases(60%),while syncope occurred in 2(40%).PETCT revealed focal or patchy myocardial glucose hypermetabolism in all patients,with pulmonary or lymph node involvement.Electrocardiography showed ventricular tachycardia(VT)in 4 cases(80%)and high-grade atrioventricular block(AVB)in 2(40%).All cases were diag-nosed using clinical criteria and received corticosteroid immunosuppressive therapy.Methotrexate was combined in 2 patients(40%),implantable cardioverter defibrillator(ICD)were placed in 4(80%),and 1 patient(20%)underwent repeated radiof-requency ablation for ventricular arrhythmias.Conclusion CS patients often initially present with arrhythmia,where high-grade AVB and VT are critical warning signs.Imaging examinations such as PETCT facilitate diagnosis,immunosuppressive therapy is the primary treatment,and ICD implantation is indicated for high-risk patients with potential sudden cardiac death.