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1.
Am J Case Rep ; 22: e928852, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33446625

RESUMO

BACKGROUND Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the lungs but can involve any organ. The medical community is struggling to cope with the critical illness associated with the disease. On top of that, patients who have recovered from COVID-19 have presented with complications such as thrombotic episodes in various organs both during and after being infected with SARS-CoV-2. A COVID-19-associated prothrombotic state has been mentioned in multiple recent research articles. The role of anticoagulants is debatable, because even after receiving them prophylactically, many patients have experienced thrombotic episodes. The situation, therefore, represents a challenge to the medical community. CASE REPORT We report on a COVID-19-associated prothrombotic state in a 65-year-old man with no history of comorbid illness. Initially, he presented with right-sided weakness and was found to have had an acute ischemic stroke. Urgent imaging after the stroke revealed changes on electrocardiography that were remarkable for left bundle branch block. The patient's elevated cardiac enzyme levels correlated with a silent acute myocardial infarction (MI). His echocardiogram revealed a left ventricular (LV) thrombus. He was managed with a multidisciplinary approach involving Neurology, Cardiology, and Medicine. CONCLUSIONS COVID-19-associated prothrombotic episodes involving arterial and venous systems have been reported in the literature. But concomitant stroke, acute MI, and LV thrombus rarely have been documented. The role of prophylactic or therapeutic anticoagulation is still unclear because even when patients are on these drugs, they continue to develop thrombotic episodes. Indeed, further studies are required to develop a standard management plan for what can be a fatal situation.


Assuntos
COVID-19/complicações , AVC Isquêmico/virologia , Infarto do Miocárdio/virologia , Trombose/virologia , Idoso , Bloqueio de Ramo/diagnóstico , Bloqueio de Ramo/virologia , COVID-19/diagnóstico , Ecocardiografia , Ventrículos do Coração/diagnóstico por imagem , Humanos , AVC Isquêmico/diagnóstico por imagem , Masculino , Infarto do Miocárdio/diagnóstico , Trombose/diagnóstico por imagem , Tomografia Computadorizada por Raios X
2.
J Int Med Res ; 31(3): 244-6, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12870380

RESUMO

We describe a 32-year-old man with electrocardiographic (ECG) changes consistent with Brugada syndrome and influenza virus infection. The ECG pattern changed after 1 week to one of early repolarization in V1 and V2. This case suggests an association between Brugada syndrome and viral infection.


Assuntos
Bloqueio de Ramo/diagnóstico , Bloqueio de Ramo/virologia , Eletrocardiografia , Influenza Humana/complicações , Adulto , Humanos , Masculino , Complexos Ventriculares Prematuros/diagnóstico , Complexos Ventriculares Prematuros/virologia
3.
Cardiol Rev ; 11(1): 45-9, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12493136

RESUMO

The Brugada syndrome is characterized by a distinct ECG pattern consisting of ST segment elevation in the right precordial leads and right bundle branch block, a propensity for life-threatening arrhythmias, and an apparently structurally normal heart. The authors describe the case of a patient with an aborted sudden cardiac death and the typical ECG signs of Brugada syndrome. Nevertheless, magnetic resonance imaging displayed signal enhancement in the left ventricular myocardium. Additionally, histologic examination, in-situ hybridization, and PCR revealed evidence of a locally restricted inflammation due to parvovirus B19. Brugada syndrome is regarded as a primary electrical disease due to dysfunction of distinctive ion channels, but focal myocarditis may serve as a trigger for ventricular arrhythmias in this patient. Further morphologic studies will be helpful to establish the possible role of structural changes in the pathophysiology of this syndrome.


Assuntos
Bloqueio de Ramo/diagnóstico , Bloqueio de Ramo/virologia , Miocardite/diagnóstico , Miocardite/virologia , Infecções por Parvoviridae , Parvovirus B19 Humano , Adulto , Bloqueio de Ramo/complicações , Angiografia Coronária , Morte Súbita Cardíaca/etiologia , Diagnóstico Diferencial , Eletrocardiografia , Humanos , Imageamento por Ressonância Magnética , Masculino , Miocardite/complicações
4.
Dtsch Med Wochenschr ; 123(48): 1443-6, 1998 Nov 27.
Artigo em Alemão | MEDLINE | ID: mdl-9858952

RESUMO

HISTORY AND CLINICAL FINDINGS: A 28-year-old woman was admitted after syncope which had been preceded by several flulike episodes. There was no history of any other serious disease. Physical examination was unremarkable. Heart sounds were regular and normal, there were no murmurs. INVESTIGATIONS: White cell count was 9400/microliter, with a normal differential count. Erythrocyte sedimentation rate and C-reactive protein were also normal. Virus serology revealed no abnormality. The electrocardiogram (ECG) showed complete (third degree) atrioventricular (AV) block with an idioventricular rhythm of 38 beats/min and right bundle branch block pattern. TREATMENT AND COURSE: A temporary transvenous pacemaker was inserted on the first hospital day. As myocarditis was suspected a right ventricular endomyocardial biopsy was obtained. Histological and immunohistological examinations demonstrated no unequivocal findings. But molecular-biological tests revealed. Coxsackie-B3 virus genome. The pacemaker was removed on the 6th day, when the ECG had shown intermittent second degree AV block. Regular sinus rhythm with a PR interval of 0.18 s was recorded on day 12, and 24-hour ECG monitoring for several days until her discharge on the 18th day confirmed this rhythm throughout. CONCLUSION: In aetiologically undetermined disease molecular-biological techniques can be indispensable for the exact diagnosis and may be decisive for administering specific treatment.


Assuntos
Infecções por Coxsackievirus/virologia , Enterovirus Humano B/genética , Genoma Viral , Bloqueio Cardíaco/virologia , Coração/virologia , Síncope/virologia , Adulto , Bloqueio de Ramo/classificação , Bloqueio de Ramo/terapia , Bloqueio de Ramo/virologia , Estimulação Cardíaca Artificial , Infecções por Coxsackievirus/classificação , Infecções por Coxsackievirus/terapia , Diagnóstico Diferencial , Eletrocardiografia , Eletrocardiografia Ambulatorial , Endocárdio/virologia , Feminino , Bloqueio Cardíaco/classificação , Bloqueio Cardíaco/terapia , Humanos , Reação em Cadeia da Polimerase , Sensibilidade e Especificidade
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