DOI: https://doi.org/10.36347/sjmcr.2026.v14i03.056

Pages: 553-559

Sarcoidosis is a granulomatous, multisystemic disease which can affect the heart and is a challenging disease to diagnose and predict. This case report emphasized the importance of multimodality imaging in detecting active Cardiac Sarcoidosis, particularly in a patient who rejected any pharmacologic treatment. The case report involved a 50-year-old female who had a five-year history of systemic sarcoidosis with recurrent palpitations. Physical examination was unremarkable, and Holter monitoring showed premature ventricular contractions with short nonsustained ventricular tachycardia. Echocardiography revealed standard structure and functioning. Monitoring with Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography scan illustrated focal hypermetabolic function in the interventricular septum (SUV max 5.14) and resolution of previous mediastinal lesions. The Magnetic Resonance Imaging of the heart revealed a normal biventricular function, no hypertrophy or late gadolinium enhancement and T1/T2 values at the upper normal limits, indicating mild inflammatory activity. Concordant Positron Emission Tomography and Magnetic Resonance Imaging supported active cardiac sarcoidosis. The case report highlighted the diagnostic utility of combined imaging and the need to follow up such patients who refuse corticosteroid therapy.