Cardiovascular Medicine. 2016;19(04):128-131. Fournier S, Regamey J, Rotman S, Pruvot E, Hullin R. This case of cardiac sarcoidosis started with manifestation of a complete AV block in a 42 years old female without other cardiac dysfunction. Two years later, the patients presented with acute heart failure symptoms at the Emergency Department. The echocardiography at admission showed thinning and hyperdensity of the basal interventricular septum which is a rare but typical echocardiographic sign of cardiac sarcoidosis. Endomyocardial biopsy, PET-CT, and transbronchial biopsy confirmed the clinical suspicion of sarcoidosis. Of note, the patient also had celiac disease which can occur conjoint with sarcoidosis. After 5 months of immunosuppressive treatment with methylprednisolone and azathioprine the burden of inflammatory lesions was significantly reduced and the patient had improved to NYHA class I.