Bhimani S, Rojulpote C, Deshpande Y, Maligireddy AR. Cardiac sarcoidosis: The role of steroid therapy in managing myocardial inflammation and arrhythmic risks. World J Cardiol 2025; 17(11): 107637 [DOI: 10.4330/wjc.v17.i11.107637]
Corresponding Author of This Article
Anand Reddy Maligireddy, MD, Department of Medicine, The Wright Center for Graduate Medical Education, Washington Avenue, Scranton, PA 18505, United States. drmaligireddy@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 26, 2025 (publication date) through Nov 21, 2025
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Publication Name
World Journal of Cardiology
ISSN
1949-8462
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Bhimani S, Rojulpote C, Deshpande Y, Maligireddy AR. Cardiac sarcoidosis: The role of steroid therapy in managing myocardial inflammation and arrhythmic risks. World J Cardiol 2025; 17(11): 107637 [DOI: 10.4330/wjc.v17.i11.107637]
Simran Bhimani, Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA 18505, United States
Chaitanya Rojulpote, Department of Cardiology, Saint Louis University, St. Louis, MO 63103, United States
Yash Deshpande, Anand Reddy Maligireddy, Department of Medicine, The Wright Center for Graduate Medical Education, Scranton, PA 18505, United States
Author contributions: Bhimani S, Rojulpote C, Deshpande Y, and Maligireddy AR conceptualized and designed the manuscript; Bhimani S and Deshpande Y drafted the initial sections; Rojulpote C contributed to the literature synthesis; Maligireddy AR critically revised the manuscript and coordinated final edits; all authors reviewed and approved the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anand Reddy Maligireddy, MD, Department of Medicine, The Wright Center for Graduate Medical Education, Washington Avenue, Scranton, PA 18505, United States. drmaligireddy@gmail.com
Received: March 28, 2025 Revised: May 15, 2025 Accepted: October 22, 2025 Published online: November 26, 2025 Processing time: 238 Days and 14.5 Hours
Abstract
Cardiac sarcoidosis (CS) is a rare but serious manifestation of sarcoidosis that can lead to significant morbidity and mortality due to arrhythmias and heart failure. The inflammatory process in CS is characterized by the formation of non-caseating granulomas in the myocardium, which can disrupt normal cardiac function and conduction. Corticosteroids are the primary therapeutic agents used to manage CS, particularly during the acute inflammatory phase, as they help reduce inflammation and improve cardiac function. However, the long-term use of steroids poses risks, including opportunistic infections and metabolic complications. Advanced imaging techniques, such as cardiac magnetic resonance imaging and positron emission tomography, play a crucial role in diagnosing CS and assessing myocardial involvement. These imaging modalities also aid in risk stratification for arrhythmic events, guiding therapeutic decisions such as the initiation of steroid therapy and the potential placement of implantable cardioverter-defibrillators. This review synthesizes current evidence regarding the role of steroid therapy in managing CS and its implications for cardiac arrhythmias, emphasizing the need for individualized treatment strategies to optimize patient outcomes.
Core Tip: Cardiac sarcoidosis is a potentially life-threatening condition characterized by granulomatous inflammation of the myocardium, leading to conduction abnormalities, heart failure, and arrhythmias. This review highlights the central role of corticosteroid therapy in controlling myocardial inflammation and improving cardiac function. It also underscores the limitations of long-term steroid use and the importance of advanced imaging-such as cardiac magnetic resonance imaging and positron emission tomography-in guiding diagnosis, treatment, and arrhythmic risk stratification. A multidisciplinary approach, including immunosuppressive therapy and implantable cardioverter-defibrillator placement, is essential for optimal patient outcomes.
