Remimazolam for Procedural Sedation During Computed Tomography Angiography in a Patient With Poor Myocardial Performance Due to Cardiomyopathy

Given their cognitive and developmental status, sedation is frequently required for procedural imaging in infants and children. Although generally free of adverse effects, the agents used for procedural sedation may impact airway, hemodynamic, and respiratory function, especially in the presence of comorbid cardiac involvement. We present the use of the novel benzodiazepine, remimazolam, as the primary agent for sedation during computed tomography angiography in a 16-month-old girl who presented with myocardial dysfunction related to a primary cardiomyopathy. Potential advantages of remimazolam in this clinical scenario, along with relevant literature regarding its use in patients with comorbid cardiovascular disease, are discussed.