Concomitant Treatment of Severe Acute Respiratory Failure and Cardiac diastolic dysfunction due to Covid 19: A Case Report

ABSTRACT

Background and Aim: Although pulmonary involvement is common in Covid 19 disease, sometimes concomitant cardiac involvement is seen as diastolic dysfunction. This case report describes a patient who received simultaneous treatment for severe acute respiratory failure and cardiac diastolic dysfunction due to Covid 19. Case report A 40-year-old woman was transferred to the internal ICU of Ayatollah Rouhani Hospital in Babol because of severe respiratory distress. The patient was anxious, restless,and cyanotic. There was respiratory distress, hypoxia (72% oxygen saturation), and cardiac involvement as diastolic dysfunction. Heart rate was 134/min, blood pressure 122/78 mm Hg, and respiratory rate 38/min. The patient underwent non-invasive ventilation, and received beta-interferon, low-dose furosemide, bisoprolol, and spironolactone. During the course of treatment, despite receiving a prophylactic dose of subcutaneous heparin, the patient developed deep vein thrombosis of the left lower extremity and was treated with intravenous heparin. After two weeks, the patient was discharged in relatively good condition with non-invasive ventilation, spironolactone, and oral rivaroxaban. After three months, CT scan of the lungs and echocardiography became normal. Conclusion: Examination of the patients for cardiac diastolic dysfunction as a concomitant disease is recommended. In case of occurrence of this disorder in Covid 19 patients, treatment of cardiac diastolic dysfunction in addition to severe pulmonary involvement should be taken into concideation.