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.

A 42-year-old female with a past medical history significant for scleroderma and extensive tobacco use presented with a dry cough and pleuritic chest pain. Further workup was significant for leukocytosis, macrocytic anemia, left lower lung mass, bilateral supraclavicular, hilar, and mediastinal lymphadenopathy. After a comprehensive rheumatologic workup was completed, the patient was found to have strongly positive antinuclear antibody (ANA) and negative scleroderma-specific antibodies with fluorescent ANA indicating a nucleolar pattern. We present a case of paraneoplastic scleroderma in the setting of lung adenocarcinoma which emphasizes the bidirectional relationship that exists between malignancy and rheumatic diseases.

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Naloxone-induced noncardiogenic pulmonary edema (NCPE) is a scarcely reported side effect that can occur after naloxone administration. We present a case of a 46-year-old male who presented to the emergency department for further management of an opioid overdose, who developed acute hypoxic respiratory failure after several doses of naloxone. The rapid deterioration of the patient’s respiratory status required increased supplemental oxygen, with plane film radiography suggesting diffuse pulmonary edema. This case emphasizes the importance of understanding the significant side effects of a lifesaving drug and the implications they carry now that naloxone is available without prescription.