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Cardiopulmonary Exercise Test in the Detection of Unexplained Post-COVID-19 Dyspnea.
Djokovic, Danijela; Nikolic, Maja; Muric, Nemanja; Nedeljkovic, Ivana; Simovic, Stefan; Novkovic, Ljiljana; Cupurdija, Vojislav; Savovic, Zorica; Vuckovic-Filipovic, Jelena; Susa, Romana; Cekerevac, Ivan.
  • Djokovic D; Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac.
  • Nikolic M; Clinic for Psychiatry, Clinical Center Kragujevac.
  • Muric N; Department of Physiology, Faculty of Medical Sciences, University of Kragujevac.
  • Nedeljkovic I; Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac.
  • Simovic S; Clinic for Psychiatry, Clinical Center Kragujevac.
  • Novkovic L; Department of Internal Medicine, School of Medicine, University of Belgrade.
  • Cupurdija V; Clinic for Cardiology, Clinical Center Serbia.
  • Savovic Z; Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac.
  • Vuckovic-Filipovic J; Clinic for Cardiology, Clinical Center Kragujevac.
  • Susa R; Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac.
  • Cekerevac I; Clinic for Pulmology, Clinical Center Kragujevac.
Int Heart J ; 62(5): 1164-1170, 2021 Sep 30.
Article in English | MEDLINE | ID: covidwho-1496595
ABSTRACT
There is emerging evidence of prolonged recovery in survivors of coronavirus disease 2019 (COVID-19), even in those with mild COVID-19. In this paper, we report a case of a 39-year-old male with excessive body weight and a history of borderline values of arterial hypertension without therapy, who was mainly complaining of progressive dyspnea after being diagnosed with mild COVID-19. According to the recent guidelines on the holistic assessment and management of patients who had COVID-19, all preferred diagnostic procedures, including multidetector computed tomography (CT), CT pulmonary angiogram, and echocardiography, should be conducted. However, in our patient, no underlying cardiopulmonary disorder has been established. Therefore, considering all additional symptoms our patient had beyond dyspnea, our initial differential diagnosis included anxiety-related dysfunctional breathing. However, psychiatric evaluation revealed that our patient had only a mild anxiety level, which was unlikely to provoke somatic complaints. We decided to perform further investigations considering that cardiopulmonary exercise test (CPET) represents a reliable diagnostic tool for patients with unexplained dyspnea. Finally, the CPET elucidated the diastolic dysfunction of the left ventricle, which was the most probable cause of progressive dyspnea in our patient. We suggested that, based on uncontrolled cardiovascular risk factors our patient had, COVID-19 triggered a subclinical form of heart failure (HF) with preserved ejection fraction (HFpEF) to become clinically manifest. Recently, the new onset, exacerbation, or transition from subclinical to clinical HFpEF has been associated with COVID-19. Therefore, in addition to the present literature, our case should warn physicians on HFpEF among survivors of COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Dyspnea / Exercise Test / COVID-19 Type of study: Case report / Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Adult / Humans / Male Language: English Journal: Int Heart J Journal subject: Cardiology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Dyspnea / Exercise Test / COVID-19 Type of study: Case report / Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Adult / Humans / Male Language: English Journal: Int Heart J Journal subject: Cardiology Year: 2021 Document Type: Article