A 41-year-old man who presented with a history of sudden loss of consc
iousness suffered two further episodes during which asystole was docum
ented. Subsequent investigations included exercise stress testing, tha
llium scintigraphy, electrophysiological studies, CT-scan of chest, Kv
eim test and a gallium-67 scan, which led to a presumptive diagnosis o
f averted sudden death as a first presentation of sarcoidosis with pri
mary cardiac involvement.