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Cardiovasc Diagn Ther ; 11(6): 1228-1240, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1836243


BACKGROUND: Coronavirus associated disease 2019 (COVID-19) is associated with higher morbidity and mortality in patients with cardiovascular disease. There is a paucity of data regarding COVID-19 and cardiac disease from Africa. We aimed to describe the demographic, clinical, electrocardiographic and echocardiographic characteristics of patients with COVID-19 and cardiac disease at a tertiary hospital in South Africa. METHODS: This was a retrospective cross-sectional descriptive study (Aug 2020 to March 2021) of 200 patients with COVID-19 and confirmed cardiac disease, conducted at Chris Hani Baragwanath. Demographic, clinical, electrocardiographic and echocardiographic characteristics were systematically collected. RESULTS: Majority (86%) of patients were Africans with mean age 56.4±15.6 years (57.5% females). Fifty three percent were unemployed and 28% were pensioners. Main comorbidities were hypertension (69.5%), diabetes mellitus (31.5%) and human immunodeficiency virus (HIV) (22.5%). Majority of the patients were overweight or obese (65.5%). All except 8 patients were on chronic medication. Dyspnoea on admission was noted in 88.5% of patients. Seventy nine percent of patients had abnormal chest X-Ray. Frequently documented electrocardiography findings were sinus tachycardia (63%) and atrial fibrillation, noted in 7% of patients. The most common indication for echocardiography was heart failure (30%). Severe left ventricular dysfunction was noted in 21.5%. Features of pulmonary hypertension were present in 45.5%. The right ventricle was enlarged in 59% of patients, and functional tricuspid regurgitation was noted in 54.5%. The most common diagnoses were hypertensive heart disease with preserved ejection fraction (35.8%), cardiomyopathies (20%), cor pulmonale (15.7%), acute coronary syndrome (6.5%), infective endocarditis (5.5%) and valvular heart disease (2.5%). Echocardiography modified management in 53% of cases. An in-hospital mortality of 17.5% was noted. On multivariate logistic regression analysis sinus tachycardia was the most important independent predictor of mortality (odds ratio, OR: 2.52, 95% confidence interval, CI: 1.08-5.85, P=0.03). CONCLUSIONS: Most patients were obese females with underlying hypertension. Echocardiography altered management in about half the patients. Mortality amongst this cohort of patients was high and were predominantly males.

Cardiovasc J Afr ; 33(1): 36-40, 2022.
Article in English | MEDLINE | ID: covidwho-1771671


Pacemaker endocarditis is rare and symptoms may be misleading. If missed, it carries significant morbidity and mortality, particularly in the elderly. Advances in multi-modality imaging in recent years have emphasised its role in clinical decision making. This case highlights the ability of multi-modality imaging techniques to individualise diagnosis, management and prognosis in patients with suspected cardiovascular implantable electronic device (CIED) endocarditis.

Defibrillators, Implantable , Echocardiography, Three-Dimensional , Endocarditis , Pacemaker, Artificial , Prosthesis-Related Infections , Aged , Defibrillators, Implantable/adverse effects , Endocarditis/diagnostic imaging , Endocarditis/etiology , Endocarditis/therapy , Humans , Pacemaker, Artificial/adverse effects , Prosthesis-Related Infections/diagnostic imaging , Prosthesis-Related Infections/etiology , Prosthesis-Related Infections/therapy , Tomography
Oxf Med Case Reports ; 2021(2): omaa142, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1238225


A 31-year- old male with no comorbidities presented with chest discomfort and shortness of breath following SARS-CoV-2 infection. Primary viral myocarditis was confirmed with the aid of cardiac biomarkers and cardiac magnetic resonance (CMR) imaging. Herein, we detail his clinical presentation, management and highlight the role of CMR in viral myocarditis.