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A complete atrioventricular block case during SARS COV2pneumonia. Case Report
Italian Journal of Medicine ; 14(SUPPL 2):122-123, 2020.
Article in English | EMBASE | ID: covidwho-984491
ABSTRACT
Description of the case A 83-year-old man has been hospitalized for fever, cough and dyspnea in our UOC pneumology Covid fornasopharyngeal swab positive for SARS COV2. In anamnesis itpresented hypertension, COPD and atherosclerotic vasculopathy.At the entrance it has dyspnoea, BP 130/80 mmHg, CF 72 bpm,no heart failure symptoms, Ps 02 89% in ambient air. Pulmonaryauscultation demonstrated the presence of ronchi spreads tochest with hypomobile bases. At ECG sinus rhythm was 65 bpmwith repolarization anomalies QTc470 ms. Echocardiography wascompatible for hypertensive heart disease. Bilateral thickeningswith an emery glass appearance in the bilateral basal middle fieldat the chest CT scan. Laboratory showed the signs of inflammation.He begins antibiotic and antiviral therapy with lopinavir, LMWH,dexametazone and O2 therapy with integral mask with fi02 50%peep 10 mmHg. The respiratory symptoms have improved but itshowed up steep edema, asthenia, bradycardia with difficultyspeaking. Ecg presents complete atrioventricular block with junctional escapement at 35 bpm. Bilateral thickenings with an emeryglass appearance in the bilateral basal middle field at the chestCT scan. Laboratory showed the signs of inflammation. He beginsantibiotic and antiviral therapy with lopinavir, LMWH, dexametasone and O2 therapy with integral mask with fi02 50% peep 10mmHg. The respiratory symptoms have improved but it showed upsteep edema, asthenia, bradycardia with difficulty speaking. ECGpresents complete atrioventricular block with junctional escapement at 35 bpm. Ps O2 94% in O2 at 4 l / m. The patient waspromptly taken to the electrophysiology room for the definitive single-chamber pacemaker implant. Clinical and hemodynamic conditions have improved as well as lung and ventilator conditions.

Conclusions:

In our experience we have observed the presenceof numerous cases of heart rhythm disturbances both in the bradycardic and tachycardic sense not only iatrogenic but also suggestive of a direct action of the SARS-CoV2 virus on the cardiacconduction system.
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Collection: Databases of international organizations Database: EMBASE Type of study: Case report Language: English Journal: Italian Journal of Medicine Year: 2020 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Type of study: Case report Language: English Journal: Italian Journal of Medicine Year: 2020 Document Type: Article