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A 30-year-old male presented with dyspnoea and pulmonary oedema. Echocardiography revealed a severely reduced LV-function (EF: 25%). Coronary heart disease was excluded by angiography (Panel H). Owing to bilateral hilar lymphadenopathy on chest X-ray (Panel A), we performed a simultaneous positron emission tomography/magnetic resonance imaging (PET/MRI) study. Representative for sarcoidosis, a strong 18F-fluorodesoxyglucose (FDG) uptake under fasting conditions was located at the pulmonary lymph nodes (Panel B). On MRI, late gadolinium enhancement (LGE) was observed in the lateral wall confirming myocardial infiltration (Panel C). T2-weighted images revealed diffuse areas with an increased signal consistent with myocardial oedema (Panel D). Furthermore, reduced perfusion (Panel E) and increased FDG uptake (Panel F) in the anterolateral wall is a common finding in cardiac …