Decoding Complexity: A Multimodal Approach in the Diagnosis of Isolated Cardiac Sarcoidosis.

Sarcoidosis is a chronic inflammatory condition of uncertain origins, affecting multiple organs and characterized by the formation of granulomas. Cardiac involvement, known as cardiac sarcoidosis (CS), occurs in 5%-10% of cases and can lead to heart failure, arrhythmias, and sudden death. Distinguishing CS from other heart conditions poses a significant challenge. However, improved diagnostic techniques such as cardiac magnetic resonance (CMR) and positron emission tomography combined with computed tomography (CT) have enhanced recognition rates, replacing invasive procedures like endomyocardial biopsy. Clinical guidelines have further facilitated diagnosis. This case report underscores the diagnostic complexity of CS and highlights the emerging role of contrast-enhanced cardiac CT as a viable alternative to CMR, particularly in patients with contraindications to CMR.