Pathophysiology of stress cardiomyopathy: A comprehensive literature review.

Introduction: Takotsubo cardiomyopathy is a transient type of acute heart failure with distinct wall motion abnormalities and unclear pathophysiology. This review focuses on the proposed pathophysiological mechanisms that could be involved in the occurrence takotsubo cardiomyopathy. Main body: Acute stress and subsequent excessive activation of the sympathetic nervous system are major factors in the pathophysiology of takotsubo cardiomyopathy. The high levels of catecholamine work in a triggering manner, generate reactive oxygen species, release inflammatory cytokines, and induce endothelial injury. The incidence of Takotsubo cardiomyopathy has increased following COVID-19 infection and vaccination, which suggests that neurohormonal and psychological factors (i.e., fear and anxiety of infection or vaccination) may have an additional role in the pathophysiology. In addition, inflammatory state, cytokine storm, augmented sympathetic activity, and endothelial dysfunction during the acute phase of COVID-19 infection may participate in Takotsubo cardiomyopathy. Chronic stress is also linked to this complex mechanism by accelerating cripple of endocrinal hypothalamic-pituitary-adrenal axis activity, which influences the cortisol effect on releasing catecholamine, which is directly related to the pathogenesis of takotsubo cardiomyopathy. Conclusion: The excessive activation of the sympathetic nervous system and subsequent high levels of catecholamines could initiate the process. The catecholamines, in turn, generate reactive oxygen species and release inflammatory cytokines (i.e., IL-1, IL-2, IL-6, IL-7, IL-8, CXCL1, TNF-α, and IFN-γ), which causes endothelial injury.

Sequences of COVID-19 in a child with WAGR syndrome: A case report.

INTRODUCTION: and importance: WAGR syndrome is a rare genetic disorder consist of Wilms tumor, Aniridia, Genitourinary abnormalities, and Intellectual disability. During the enduring COVID-19 pandemic, it has become extremely important to document the properties of SARS-CoV-2 and its interactions with other diseases. Herein, we present the first case of Syrian child with WAGR syndrome that has been affected by COVID-19. CASE PRESENTATION: a 17-month-old boy was diagnosed with WAGR syndrome. During the follow-up, he developed rhinorrhea, cough, and moderate dyspnea with no fever. Computed tomography scan was normal and polymerase chain reaction test was positive. The child started an oxygen therapy with broad-spectrum antibiotics based on laboratory findings. His vital signs and laboratory values improved gradually without any further complications. DISCUSSION: COVID-19 has a special interest regarding its course in children. Although the clinical presentation varies, the current data reveal a better prognosis in children. CONCLUSION: SARS-CoV-2 infection may result in non-specific symptoms and normal CT scan findings in children with WAGR syndrome. The accurate diagnosis, effective isolation and monitoring of the child, and successful management can improve the prognosis and shorten the infection period.