| Abstract [eng] |
Sarcoidosis is a multisystemic inflammatory disease of unknown etiology, characterized by the formation of non-caseating granulomas in various organs. One of the rarer yet clinically significant manifestations of this pathology is cardiac sarcoidosis, which presents diagnostic challenges due to its nonspecific clinical presentation, difficulties in early-stage radiological imaging, and limited accessibility to advanced imaging modalities. Although cardiac involvement accounts for a minority of sarcoidosis cases, it is associated with a higher risk to vital functions and elevated mortality rates. Granulomatous infiltration may affect any cardiac structure, resulting in asymptomatic progression or clinically manifest damage, fibrosis, and functional impairment. The clinical spectrum ranges from arrhythmias to progressive heart failure and, in severe cases, sudden cardiac death. The diagnostic approach to cardiac sarcoidosis is multimodal, with nuclear medicine, particularly 18F-fluorodeoxyglucose positron emission tomography, playing a pivotal role. This imaging modality enables early detection of inflammatory activity, assessment of extracardiac involvement and objective monitoring of therapeutic efficacy, thereby contributing to the prevention of irreversible structural changes. The presented clinical case of cardiac sarcoidosis illustrates the application of multimodal imaging methods in the diagnosis of cardiac sarcoidosis, emphasizes the importance of nuclear medicine in assessing treatment efficacy and reveals the characteristics of advanced disease progression and outcomes. The objective of this thesis is to provide a comprehensive review of the existing literature on cardiac sarcoidosis, evaluate current research findings and theoretical models, and present clinical case data to highlight the complexity of cardiac sarcoidosis and associated principal diagnostic and clinical management challenges. |
