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Cardiac sarcoidosis — SCE Acute Medicine MCQ

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HardCardiovascular medicineCardiac sarcoidosisSCE Acute Medicine

A patient with systemic sarcoidosis has syncope, intermittent bundle-branch block and non-sustained ventricular tachycardia. Echocardiography shows mild LV dysfunction. What is the next investigation strategy?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Obtain cardiac MRI and prolonged rhythm monitoring

The best answer is “Obtain cardiac MRI and prolonged rhythm monitoring”. This is correct because conduction disease, ventricular arrhythmia and ventricular dysfunction are red flags for myocardial involvement. MRI characterises scar and inflammation, while ambulatory or inpatient rhythm evaluation quantifies electrical risk; FDG-PET may add activity assessment. Troponin cannot exclude disease, and delayed referral risks sudden death.

Reference: British Thoracic Society clinical statement on pulmonary sarcoidosis: https://www.brit-thoracic.org.uk/quality-improvement/clinical-statements/sarcoidosis/