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Mumbai: Raj Gorsa, a 50-year-old from Mumbai, experienced chest pain, palpitations, and blackouts while at work. He was rushed to Jaslok’s emergency department where tests revealed recurrent ventricular tachycardia, a potentially dangerous arrhythmia. Initial medication attempts failed, leading the cardiac team to implant an Automated Implantable Cardioverter Defibrillator (AICD). Additional probing uncovered the underlying causes of Gorsa’s heart troubles: a concurrent manifestation of tuberculosis (TB), a prevalent respiratory ailment, and cardiac sarcoidosis, an uncommon inflammatory condition impacting the heart muscle. Dr. Rahul Chabbria, consultant cardiologist at Jaslok, explained, "This combination is exceptionally rare. Diagnosing it necessitates a high index of suspicion and the combined expertise of various specialists." Led by Dr. Ashwin Mehta, Director of Cardiology at Jaslok, a team comprising imaging specialists, electrophysiologists, interventional cardiologists, and intensivists collaborated to reach the diagnosis and plan optimal treatment. This team also included Dr. Upendra Bhalerao, consultant cardiovascular and thoracic surgeon, Dr. Ameya Udayavar, consultant electrophysiology, and several other specialists. Despite the AICD, Gorsa's ongoing abnormal heart rate required additional intervention, prompting him to undergo a high-risk, minimally invasive procedure known as bilateral thoracoscopic sympathectomy. This uncommon surgery, usually reserved as a final option, entails severing specific sympathetic nerves responsible for regulating heart rate. Dr. Bhalerao, serving as the lead surgeon, conducted the intricate procedure utilizing thoracoscopic techniques to reduce invasiveness. Dr. Rahul Chabbria, a cardiologist at Jaslok, remarked, "This is an exceptionally rare case. The combined expertise of our multidisciplinary team was crucial for diagnosis and treatment." Dr. Bhalerao expressed, "The success of this surgery is a testament to our team’s dedication and collaborative approach. Gorsa’s heart rate and rhythm showed remarkable improvement, restoring normalcy." 

Gorsa, filled with profound gratitude, conveyed, "I owe my life to the Jaslok team. They remained steadfast, even during the touch-and-go moments when the AICD delivered shocks to restore my heart's rhythm." This case emphasizes the critical role of early diagnosis and coordinated care in managing complex medical conditions.