Cardiac Sarcoidosis: Diagnosis

Reviewed by Howard D. Weinberger, MD, FACC

How Is Cardiac Sarcoidosis Diagnosed?

Diagnosing cardiac sarcoidosis can be very challenging. There are no widely accepted guidelines for either screening or diagnosing sarcoidosis of the heart. Moreover, the current available diagnostic tests are variable in their ability to detect cardiac sarcoidosis. Because of the devastating nature of cardiac sarcoidosis, most people with other forms of sarcoidosis are screened for sarcoidosis of the heart.

Initial cardiac evaluation may include an electrocardiogram (EKG), a signal-averaged EKG, an echocardiogram (ultrasound of the heart) and a Holter monitor (extended EKG). Additional imaging tests may include single positron emission computed tomography (SPECT), positron emission tomography (PET), and cardiac MRI. A positive heart biopsy confirms cardiac sarcoidosis, but may more often be negative or normal even when there is sarcoidosis in the heart, especially if heart function is normal.

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