Sarcoidosis is a systemic disease, in which early inflammatory organic changes, which are often reversible under treatment, may take a subclinical course. In scarred residual tissue improvement id rare. Continuing functional loss or even organ failure is possible. The involvement of the heart is of essential prognostic value. Early onset of treatment with corticosteroids before irreversible functional loss of the heart occurs leads to an excellent prognosis. Technical progress in the imaging techniques have led to great improvement of the graphical presentation of cardiac structure and function, but not one of these techniques has yet been approved of for early diagnosis. Still, a combination of different diagnostical measures in addition to the evaluation of clinical symptoms often allows early diagnosis. A decisive factor is "to consider it" and a timely start of further diagnostics if certain symptoms are presented. Alternatives to the specific treatment with cortisone are still lacking. Symptomatic cardiac treatment is mainly oriented on the therapy of dilatory cardiomyopathies, since there are no reliable systematic studies available on questions concerning, for example, antiarrhythmic treatment or indications for the implantations of pacemakers in connection with cardiac sarcoidosis.