Cardiac sarcoidosis is a disease of young adults. In most cases, it presents with sudden death, arrhythmia, conduction disorders, heart failure, or cardiomyopathy. The authors describe a young Indo-Asian man with cardiac sarcoidosis who presented acutely with chest pain and malignant cardiac arrhythmias. The diagnosis of cardiac sarcoidosis should be considered in all young patients with unexplained arrhythmias or heart failure or in cases of sudden death.