Cardiac sarcoidosis (CS) is a rare but serious manifestation of systemic sarcoidosis that can lead to significant morbidity and mortality. While some patients present with conduction abnormalities, arrhythmias, or heart failure, others remain asymptomatic, making early detection difficult. Silent progression and the lack of disease-specific symptoms often result in delayed diagnosis, increasing the risk of sudden cardiac death.Diagnosing CS remains a challenge due to its patchy myocardial involvement, which limits the sensitivity of endomyocardial biopsy. Cardiac MRI and PET-CT are valuable imaging modalities that improve diagnostic accuracy, yet they are not always definitive. A comprehensive assessment combining imaging techniques, ECG findings, and laboratory markers is often necessary to establish the diagnosis. The early identification of CS is crucial to prevent irreversible myocardial damage and life-threatening arrhythmias. Due to its complex presentation, a multidisciplinary approach involving cardiologists, pulmonologists, radiologists, and rheumatologists is essential for optimal patient management. Improved awareness and diagnostic strategies are key to enhancing patient outcomes and reducing the burden of undiagnosed CS.
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