RESUMEN
Left ventricular (LV) unloading has been associated with improved survival in patients treated with venoarterial extracorporeal membrane oxygenation. This case describes a patient with a COVID-19 infection who subsequently developed non-ischemic cardiomyopathy with an LV ejection fraction of 10% to 15% (baseline echocardiography). He did poorly in the outpatient setting and was admitted to an outside hospital with heart failure symptoms and was subsequently transferred to our hospital for escalation of care and consideration of advanced heart failure therapies. This clinical image and related video series help to visually demonstrate the effect of LV unloading in a 30-year-old male with a history of COVID-19 myocarditis.
Asunto(s)
COVID-19 , Oxigenación por Membrana Extracorpórea , Insuficiencia Cardíaca , Corazón Auxiliar , Masculino , Humanos , Adulto , Oxigenación por Membrana Extracorpórea/métodos , Ventrículos Cardíacos , Función Ventricular Izquierda , Choque Cardiogénico/terapiaRESUMEN
PURPOSE OF REVIEW: The COVID-19 pandemic has created unprecedented challenges globally, with significant strain on the healthcare system in the United States and worldwide. In this article, we review the impact of COVID-19 on percutaneous coronary interventions and structural heart disease practices, as well as the impact of the pandemic on related clinical research and trials. We also discuss the consensus recommendations from the scientific societies and suggest potential solutions and strategies to overcome some of these challenges. FINDINGS: With the limited resources and significant burden on the healthcare system during the pandemic, changes have evolved in practice to provide care to the highest risk patients while minimizing unnecessary exposure during elective surgical or transcatheter procedures. The COVID-19 crisis has significantly impacted the management of patients with acute coronary syndromes, chronic coronary syndromes, and structural heart disease.
Asunto(s)
COVID-19 , Cardiopatías , Consenso , Procedimientos Quirúrgicos Electivos , Humanos , Pandemias/prevención & control , Estados UnidosRESUMEN
The COVID-19 pandemic has affected millions of patients across the globe. Multiple studies, national and international governmental data have shown important sex and gender differences in the incidence and outcomes of patients with COVID-19. These differences are not only attributed to the differences in age and comorbid conditions but likely a combination of factors, including hormonal differences, immune response, inflammatory markers and behavioral attitudes, among others. In this review, we discuss the studies addressing sex- and gender-specific differences in COVID-19 infections with a focus on the potential pathophysiological mechanisms of these differences.
RESUMEN
With the advent of the COVID-19 pandemic in the United States, resources have been reallocated and elective cases have been deferred to minimize the spread of the disease, altering the workflow of cardiac catheterization laboratories across the country. This has in turn affected the training experience of cardiology fellows, including diminished procedure numbers and a narrow breadth of cases as they approach the end of their training before joining independent practice. It has also taken a toll on the emotional well-being of fellows as they see their colleagues, loved ones, patients or even themselves struggling with COVID-19, with some succumbing to it. The aim of this opinion piece is to focus attention on the impact of the COVID-19 pandemic on fellows and their training, challenges faced as they transition to practicing in the real world in the near future and share the lessons learned thus far. We believe that this is an important contribution and would be of interest not only to cardiology fellows-in-training and cardiologists but also trainees in other procedural specialties.