Therapeutic modalities - including corticosteroids, immunosuppressants, biologics (e.g., TNF inhibitors, IL-1/IL-18 blockers), and mechanical support (LVAD, transplantation) - are critically appraised based on existing clinical and registry evidence.<h4>Results</h4>Morphological evidence suggests cardiac involvement in 20%-30% of sarcoidosis cases, yet clinically manifest CS is diagnosed in only ∼5%. This evidence concerns the gene TNF and Cowden syndrome 1.