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The purpose of this prospective study in 66 patients with acute ischemic heart disease was to analyze the possible effects of moderately elevated levels of carboxyhemoglobin (COHb) on the early course of this disease. Thirty-one patients presented with a level of COHb ≤2% and 35 with a level of > 2%. In the group with elevated COHb, more patients developed transmural infarction, but the difference was not significant (p = 0.123). Patients with transmural infarction had higher maximum CPK values (p < 0.01), when COHb levels were > 2%. During the first 6 h after admission to hospital, these patients needed an antiarrhythmic treatment significantly more frequently (p = 0.003). Differences in rhythm disorders were still present at a time when nicotine, due to its short biological half-life, was already eliminated. We conclude that a moderately elevated level of COHb is not just a marker for recent smoking but may aggravate the course of acute ischemic heart disease.

In patients with suspected sarcoidosis histological confirmation is generally desired. In 40 patients with the ultimate diagnosis of sarcoidosis transbronchial lung biopsy during fiberoptic bronchoscopy revealed in 83% noncaseating granulomas. With 5 biopsies per patient a positive result was obtained in 20 of 25 patients (80%) with radiographic stage I disease, in 6 of 7 (85%) with stage II disease and in 7 of 8 (87%) with stage III disease. The only complications were two small pneumothoraces and two hemorrhages. Transbronchial biopsy with its low morbidity and high diagnostic yield can be recommended as an initial procedure in diagnosing sarcoidosis.

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