Cardiac Sarcoidosis: A Case Report on the Role of Cardiac Computed Tomography (CT) in the Evaluation of Advanced Atrioventricular Block.

Cardiac sarcoidosis is a rare autoimmune condition that is characterized by the presence of non-caseating granulomas in the cardiac tissue. We present the case of a 31-year-old male with no significant past medical history who presented with palpitations and lightheadedness during exertion for two to three months and was found to have complete heart block on his 12-lead electrocardiogram. A cardiac CT was obtained to rule out an ischemic event, but it indicated findings suggestive of pulmonary sarcoidosis. The CT findings helped tremendously with narrowing down the differential diagnosis and providing efficient diagnostic and therapeutic management.

Characteristics and Outcomes of In-Hospital Cardiac Arrest Events During the COVID-19 Pandemic: A Single-Center Experience From a New York City Public Hospital.

BACKGROUND: Patients hospitalized for severe coronavirus disease 2019 (COVID-19) infection are at risk for in-hospital cardiac arrest (IHCA). It is unknown whether certain characteristics of cardiac arrest care and outcomes of IHCAs during the COVID-19 pandemic differed compared with a pre-COVID-19 period. METHODS: All patients who experienced an IHCA at our hospital from March 1, 2020 through May 15, 2020, during the peak of the COVID-19 pandemic, and those who had an IHCA from January 1, 2019 to December 31, 2019 were identified. All patient data were extracted from our hospital's Get With The Guidelines-Resuscitation registry, a prospective hospital-based archive of IHCA data. Baseline characteristics of patients, interventions, and overall outcomes of IHCAs during the COVID-19 pandemic were compared with IHCAs in 2019, before the COVID-19 pandemic. RESULTS: There were 125 IHCAs during a 2.5-month period at our hospital during the peak of the COVID-19 pandemic compared with 117 IHCAs in all of 2019. IHCAs during the COVID-19 pandemic occurred more often on general medicine wards than in intensive care units (46% versus 33%; 19% versus 60% in 2019; P<0.001), were overall shorter in duration (median time of 11 minutes [8.5-26.5] versus 15 minutes [7.0-20.0], P=0.001), led to fewer endotracheal intubations (52% versus 85%, P<0.001), and had overall worse survival rates (3% versus 13%; P=0.007) compared with IHCAs before the COVID-19 pandemic. CONCLUSIONS: Patients who experienced an IHCA during the COVID-19 pandemic had overall worse survival compared with those who had an IHCA before the COVID-19 pandemic. Our findings highlight important differences between these 2 time periods. Further study is needed on cardiac arrest care in patients with COVID-19.

Acute myocardial infarction on Nongated chest computed tomography.

Contrast-enhanced chest computed tomography (CT) is not considered part of the evaluation of myocardial infarction. However, acute myocardial infarction has been detected on contrast-enhanced chest CT as areas of decreased myocardial enhancement in patients evaluated for other indications, such as pulmonary embolism and aortic dissection. We present a case of acute myocardial infarction on a nongated chest CT in a 67-year-old male who presented with atypical chest pain and initial nondiagnostic electrocardiogram. This case highlights that acute myocardial infarction may be detectable on contrast-enhanced CT. When evaluating contrast-enhanced chest CT's for other etiologies of chest pain, radiologists should look for potential myocardial perfusion abnormalities that can provide clues to the presence of myocardial infarction.