This report presents a case of cardiac
sarcoidosis initially manifested with
atrial fibrillation. This behavior is very uncommon in spite of the fact that the disease is multisystemic, affecting predominantly the lungs. It is emphasized that the diagnosis of the cardiac involvement is difficult, and when this occurs, can lead to conducting system disturbances,
heart failure or
sudden death (SD). The diagnosis can be made by evaluating the clinical manifestations, the noninvasive tests like ECG, Holter monitoring, chest radiography, thoracic computed tomography, magnetic resonance image and positron emission tomography. In general,
sarcoidosis is treated with
steroid compounds with good outcome, mainly when performed in the initial phases of the disease. Other cardiac manifestations, such as arrhythmias,
atrioventricular block or
heart failure, are managed similar to other
cardiomyopathies.