A cardiac manifestation in patients with COVID-19: a case series

Authors

  • Archita Ravindranath Department of Medicine, Bowring and Lady Curzon Hospital, Bangalore, Karnataka, India
  • Madhumati Ramaiah Department of Medicine, Bowring and Lady Curzon Hospital, Bangalore, Karnataka, India
  • Parvaiz Kadloor Department of Cardiology, Charaka Superspeciality Hospital, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20205484

Keywords:

COVID-19, Cardiovascular system, Myocardial infarction, Heart block

Abstract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus or the coronavirus 2019 (COVID-19) infection is a novel viral infection causing the 2020 pandemic affecting primarily the respiratory system in the form of influenza like illness, severe acute respiratory illness or asymptomatic respiratory illness and other systems. The cardiovascular system may also be affected, with or without a prior history of cardiovascular diseases. Myocardial injury is common among patients hospitalized with COVID-19 due to stress cardiomyopathy, hypoxic injury, ischemic injury due to cardiac microvascular damage or epicardial coronary artery disease and cytokine storm, however rhythm abnormalities is affected rarely in a transient or severe manner causing rhythm disturbances. The concerns about COVID‐19 may result in a delay in proper approach and prompt management in many emergent medical conditions, such as cardiovascular problems. Here, we describe our experience with 4 COVID-19 patients with varied cardiac manifestations presenting to our hospital during the months of September- October 2020.

Author Biographies

Archita Ravindranath, Department of Medicine, Bowring and Lady Curzon Hospital, Bangalore, Karnataka, India

Physician, Department of Internal Medicine

Madhumati Ramaiah, Department of Medicine, Bowring and Lady Curzon Hospital, Bangalore, Karnataka, India

Professor, Department of Internal Medicine

Parvaiz Kadloor, Department of Cardiology, Charaka Superspeciality Hospital, Bangalore, Karnataka, India

Cardiologist, Charaka Superspeciality Hospital

References

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708-20.

Fried JA, Ramasubbu K, Bhatt R. The variety of cardiovascular presentations of COVID-19. Circulation. 2020;141(23):1930-6.

Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-2.

Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020;17(5):259-60.

Xiong TY, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: acute and long-term implications. Eur Heart J. 2020;41(19):1798-800.

Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, et al. COVID-19 and Cardiovascular Disease. Circulation. 2020;141(20):1648-55.

Schoenhagen P, Tuzcu EM, Ellis SG. Plaque vulnerability, plaque rupture, and acute coronary syndromes: (multi)-focal manifestation of a systemic disease process. Circulation. 2002;106(7):760-2.

Gupta MD, Qamar A, Girish MP, Safal S, Batra V, Basia D, Mandal SK, Yusuf J, Mukhopadhyay S, Bansal A. Bradyarrhythmias in patients with COVID-19: a case series. Indian Pacing Electrophysiol J. 2020;20(5):211-2.

Driggin E, Madhavan MV., Bikdeli B. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75(18):2352-71.

Zhou F, Yu T, Du R. Clinical course and risk factors for mortality of adult inpatients with COVID‐19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054‐62.

Guzik TJ, Mohiddin SA, Dimarco Al. COVID‐19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 2020.

Guo J, Huang Z, Lin L, Lv J. Coronavirus disease 2019 (COVID‐19) and cardiovascular disease: a viewpoint on the potential influence of angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers on onset and severity of severe acute respiratory syndrome coronavirus 2 infection. J Am Heart Assoc. 2020;9(7):e016219.

Zhou F, Yu T. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.

South AM, Diz DI, Chappell MC. COVID-19, ACE2, and the cardiovascular consequences. Am J Physiol Heart Circulat Physiol. 2020.

Li J, Wang X, Chen J, Zhang H, Deng A. Association of renin-angiotensin system inhibitors with severity or risk of death in patients with hypertension hospitalized for coronavirus disease 2019 (COVID-19) infection in Wuhan, China. J Am Med Assoc Cardiol. 2020.

Janardhanan R. Myocarditis with very high troponins: risk stratification by cardiac magnetic resonance. J Thorac Dis. 2016;8:E1333-6.

Zisman LS. ACE and ACE2: a tale of two enzymes. Eur Heart J. 2005;26:322-4.

Schamroth L. An introduction to electrocardiography. Academic Medic. 1964;39(10):977.

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Published

2020-12-22

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Section

Case Series