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Complete Heart Block as a Clinical Feature in Critically Ill Coronavirus Disease 2019 (COVID-19) Patients: A Case Series of Three Cases.
Ahmad, Farook; Gandre, Priti; Nguekam, Julien; Wall, Alanna; Ong, ShiYu; Karuppamakkantakath, Abdul N; Tasopoulos, Konstantinos; Sadiq, Muhammad Athar; Kasim, Sazzli; Cuesta, Jeronimo M.
  • Ahmad F; Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK.
  • Gandre P; Cardiology Unit, Medical Department of Universiti Teknologi MARA (UiTM) Sungai Buloh, Malaysia.
  • Nguekam J; Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK.
  • Wall A; Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK.
  • Ong S; Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK.
  • Karuppamakkantakath AN; Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK.
  • Tasopoulos K; Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK.
  • Sadiq MA; Critical Care Unit, North Middlesex University, Hospital NHS Trust, Sterling Way, London N18 1QX, UK.
  • Kasim S; Cardiology Unit, Department of Medicine, Sultan Qaboos University, Muscat 123, Oman.
  • Cuesta JM; Cardiology Unit, Medical Department of Universiti Teknologi MARA (UiTM) Sungai Buloh, Malaysia.
Case Rep Crit Care ; 2021: 9955466, 2021.
Article in English | MEDLINE | ID: covidwho-1356986
ABSTRACT
Background. Novel coronavirus-19 disease (COVID-19) is associated with significant cardiovascular morbidity and mortality. However, there have been very few reports on complete heart block (CHB) associated with COVID-19. This case series describes clinical characteristics, potential mechanisms, and short-term outcomes of critically ill COVID-19 patients complicated by CHB. Case Summary. We present three cases of new-onset CHB in critically ill COVID-19 patients. Patient 1 is a 41-year-old male with well-documented history of Familial Mediterranean Fever (FMF) who required mechanical ventilator support for acute hypoxic respiratory failure from severe COVID-19 pneumonia. He developed new-onset CHB without a hemodynamic derangement but subsequently had acute coronary syndrome complicated by cardiogenic shock. Patient 2 is a 77-year-old male with no past medical history who required intubation for severe COVID-19 pneumonia acute hypoxic respiratory failure. He developed CHB with sinus pause requiring temporary pacing but subsequently developed multiorgan failure. Patient 3 is 36-year-old lady 38 + 2 weeks pregnant, gravida 2 para 1 with no other medical history, who had an emergency Lower Section Caesarean Section (LSCS) as she required intubation for acute hypoxic respiratory failure. She exhibited new-onset CHB without hemodynamic compromise. The CHB resolved spontaneously after 24 hours. Discussion. COVID-19-associated CHB is a very rare clinical manifestation. The potential mechanisms for CHB in patients with COVID-19 include myocardial inflammation or direct viral infiltration as well as other causes such as metabolic derangements or use of sedatives. Patients diagnosed with COVID-19 should be monitored closely for the development of bradyarrhythmia and hemodynamic instability.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Prognostic study Language: English Journal: Case Rep Crit Care Year: 2021 Document Type: Article Affiliation country: 2021

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Prognostic study Language: English Journal: Case Rep Crit Care Year: 2021 Document Type: Article Affiliation country: 2021