Cardiac Sarcoidosis Diagnostic Probability Score (HRS adaptation)

Myocardial biopsy shows non-caseating granulomas

Histologic extracardiac sarcoidosis confirmed

High-grade AV block (Mobitz II or third-degree)

Unexplained sustained ventricular tachycardia

Left ventricular ejection fraction (LVEF) %

Cardiac FDG-PET: focal/patchy uptake consistent with CS

Cardiac MRI (CMR): LGE pattern typical/compatible with CS

Myocardial perfusion defect (SPECT/PET) consistent with CS

Steroid-responsive cardiomyopathy or heart block

Reasonable alternative diagnoses excluded

Cardiac Sarcoidosis Diagnostic Probability Score (HRS adaptation): Explanation and Clinical Context
This calculator operationalizes the 2014 Heart Rhythm Society (HRS) consensus statement on cardiac sarcoidosis. A definitive diagnosis requires myocardial biopsy showing non-caseating granulomas, whereas a probable diagnosis requires histologically proven extracardiac sarcoidosis plus one or more typical cardiac features and exclusion of other causes. Typical cardiac features include high-grade AV block, sustained VT, unexplained reduced LVEF, characteristic FDG-PET uptake, CMR with LGE, perfusion defect compatible with CS, or steroid-responsive cardiomyopathy. The exploratory probability index is a heuristic, non-validated scoring framework designed to approximate diagnostic confidence, not to replace the categorical HRS definitions.

References:
Birnie DH, et al. Heart Rhythm. 2014;11:1305–1323.
Lehtonen J, et al. Eur Heart J. 2023;44:1495–1514.
Freeman AM, et al. Am J Cardiol. 2013;112:280–285.
Crouser ED, et al. Am J Respir Crit Care Med. 2020.
Aftab A, et al. Front Cardiovasc Med. 2024.

Appcardio may contain errors. Always verify the calculation and its accuracy before clinical use.