Cardiac sarcoidosis (CS) represents a rare yet potentially life-threatening condition characterized by non-specific clinical symptoms that maybe easily missed by clinicians. In this case series, the clinical presentations, various imaging modalities' characteristics, and the management of four patients, each with distinct phenotypes of CS confirmed through endomyocardial biopsy, are discussed. Advanced imaging techniques, including positron emission tomography, revealed the focal septal uptake of F fluorodeoxyglucose, which suggests an ongoing inflammation, whereas contrast-enhanced cardiac magnetic resonance demonstrates septal late gadolinium enhancement, which indicates replacement fibrosis. These features of multimodality imaging in CS can assist in patient diagnosis and treatment.
