A Case of Cardiac Sarcoidosis Presenting with a Low-level Elevation of Troponin: Case Report and Literature Review

Cardiac sarcoidosis (CS) is a rare complication of systemic sarcoidosis, which can occur independently or concurrently with systemic sarcoidosis. The clinical manifestations range from asymptomatic myocardial granulomas to arrhythmias, heart failure, or cardiogenic sudden death, significantly increasing the mortality rate associated with sarcoidosis. Early diagnosis and treatment of CS is crucial, especially for patients with limited symptoms of systemic sarcoidosis. In patients with confirmed systemic sarcoidosis, cardiac sarcoidosis (CS) frequently exhibits a clinically silent phenotype, typically manifesting several years subsequent to the initial onset of systemic sarcoidosis manifestations. To date, no definitive evidence substantiates the utility of serum biomarkers for CS screening, and data regarding their efficacy in CS diagnosis and clinical management remain limited. We report a case of an asymptomatic, untreated patient with pulmonary sarcoidosis, who repeatedly had mild elevation of high-sensitivity cardiac troponin T(hs-cTnT), with no abnormalities in electrocardiogram or echocardiography. Eventually, Cardiac Magnetic Resonance (CMR) examination confirmed the diagnosis of cardiac sarcoidosis, and the patient's indicators improved after immunosuppressant treatment. We conducted a literature search to evaluate the effectiveness of hs-cTnT as a screening tool for CS, providing a reference for the management of CS in clinical practice.