Background Northern Italy is one of the epicenters of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV 2) pandemic in Europe. The impact of the pandemic and the consequent lockdown on medical emergencies other than those SARS‐CoV 2 pandemic related is largely unknown. The aim of this study was to analyze the epidemiologic impact of coronavirus disease 2019 pandemic on hospital admission for severe emergent cardiovascular diseases ( SECD s) in a single Northern Italy large tertiary referral center. Methods and Results We quantified SECD s admissions to the Cardiology Division of Udine University Hospital between March 1, 2020 and March 31, 2020 and compared them with those of the same time frame during 2019. Compared with March 2019, we observed a significant reduction in all SECD s admissions: −30% for ST ‐segment–elevation acute coronary syndromes, −66% for non‐ ST ‐segment–elevation acute coronary syndromes and −50% for severe bradyarrhythmia. Conclusions A significant decrease in all SECD s admissions has been observed during the SARS‐CoV 2. pandemic and was unlikely caused by a reduction in the incidence of cardiovascular diseases. Fear of contagion may have contributed to the unpredictable drop of SECD s. Social education about early recognition of symptoms of life‐threatening cardiac conditions requiring appropriate care in a timely fashion may help to reduce this counterproductive phenomenon.

Early identification and management of potentially life-threatening cases is challenging in the ED, so that a mycologist service on call is highly advisable, especially during periods characterized by the highest incidence of poisoning.

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Sudden cardiac death (SCD) is the most life-threating complication of hypertrophic cardiomyopathy (HC). ESC Guidelines suggest the implantation of a ICD in primary prevention according to a 5year Risk SCD score ≥ 6%. The aim of the study is to evaluate the prognostic role of late gadolinium enhancement (LGE) in patients with a 5-year Risk SCD score <6%. In this multicenter study, we performed CMR in 354 consecutive HC patients (257 males, range of age 54±17) with a risk SCD score <6% (302 with <4% and 52 with ≥4 and <6% risk). Hard cardiac events, including SCD, resuscitated cardiac arrest, appropriate ICD interventions, sustained ventricular tachycardia, occurred in 22 patients. LGE was detected in a high proportion (92%) of patients with hard cardiac events (p =0.002). At ROC curve analysis, LGE extent ≥10% was the best threshold to predict major arrhythmic events (AUC 0.74). Kaplan-Meier curves showed that patients with LGE≥10% had a worse prognosis than those with lower extent (p< 0.0001). LGE extent was the best independent predictor of hard cardiac events (HR 1.05; 95% CI 1.03-107; p<0.0001). The estimates 5-year risk of hard cardiac event was 2.5% (95% CI 0.8-4.2) in patients with LGE extent <10% and 23.4% (95% CI 10.2-36.5) for those with LGE extent ≥10%. In conclusion, this study demonstrates as the extent of LGE≥10% is able to recognize additional patients at increased risk for malignant arrhythmic episodes in a population with low-intermediate ESC SCD risk score.