This is a challenging case of a patient presenting with heart failure and ventricular tachycardia. A careful chart review showed that this patient had a history of breast cancer and lymphadenopathy. A neck node biopsy showed non-caseating granulomas and a diagnosis of sarcoidosis was made. As the patient developed worsening cardiomyopathy and ventricular tachycardia, evaluation by PET and CMR were performed but therapy was only minimally effective. In this interesting case, the evaluation and management of cardiac sarcoidosis are reviewed.