ABSTRACT
Patients affected by COVID-19 pneumonia may develop stress cardiomyopathy, also known as Takotsubo syndrome (TTS), at different stages during the disease and with different degrees of left ventricular dysfunction. We describe three cases of TTS in COVID-19-positive patients with different clinical presentations and outcomes. One of them died, while in the other two coronary angiography confirmed the diagnosis but was postponed until after pneumonia resolution because of the risk of virus spread. LEARNING POINTS: An association between COVID-19 and cardiac involvement is highlighted.The incidence of Takotsubo syndrome has increased during this pandemic, possibly because it is caused by acute stress.
ABSTRACT
Patients with COVID-19 pneumonia can develop heart problems and may also may be susceptible to proarrhythmia, virus-related issues such as fever, stress, electrolyte disturbance and adverse effects from the use of antiviral drugs. We report a transient Brugada-like ECG pattern without ongoing fever in a 57-year-old man, admitted with a diagnosis of COVID-19 pneumonia, who did not have syncope or a family history of sudden cardiac death. LEARNING POINTS: Patients with COVID-19 pneumonia can develop heart problems.A transient Brugada-like ECG pattern was observed in a non-febrile COVID-19 patient.SARS-CoV-2 may have a direct effect on myocardial ion channels.
Subject(s)
Anticoagulants/therapeutic use , Coronavirus Infections/drug therapy , Coronavirus/drug effects , Pneumonia, Viral/drug therapy , Aged , COVID-19 , Female , Humans , Italy , Male , Middle Aged , Pandemics , Treatment OutcomeABSTRACT
Coronavirus pneumonia (COVID-19) is a novel infectious disease with a high mortality rate due to severe acute respiratory syndrome. A 57-year-old woman was admitted to the emergency department (ED) with fever, cough, atypical chest pain, and dyspnea. She remained in the ED for about 48 h while waiting for the result of the COVID-19 oropharyngeal swab. Once she tested positive, she was hospitalized in the pneumological department with a diagnosis of pneumonia based on a chest X-ray and biochemical tests. Although azithromycin and hydroxychloroquine were promptly administered, she had a worsening of dyspnea even with a high-flow oxygen mask. D-dimer was increased, and a computed tomography scan with pulmonary and leg angiogram was positive for bilateral pulmonary embolism, deep-venous thrombosis, and multiple consolidated opacities in the lung parenchyma. This case highlights the fact that, in a pandemic situation, there is a potentially fatal risk of overlooking an alternative diagnosis in a COVID-19 patient who is generally considered as suffering only from pneumonia.