Spectrum of Cardiac Involvement in COVID-19

Curēus
Gauravpal S GillAlexander Papolos

Abstract

Cardiac involvement in coronavirus disease 2019 (COVID-19) commonly accompanies multi-organ system failure with acute respiratory syndrome; however, infrequently myocarditis and pericardial effusions may be isolated, yet fulminant. In this report, we highlight significant variations in cardiac involvement and presentation among patients with COVID-19. This article reports two cases of fulminant myocarditis in COVID-19 positive patients who presented to our facility with contrasting symptoms, laboratory and imaging findings. A 65-year-old patient A had a more typical presentation including respiratory distress, chest pain, ST-segment elevations on electrocardiogram (EKG), lymphopenia, elevated levels of inflammatory markers and cardiac troponin I. A 34-year-old patient B presented with shortness of breath and chest pain similar to patient A; however, she had isolated cardiac involvement with systolic dysfunction and an acute pericardial effusion causing tamponade physiology. Inflammatory marker and cardiac troponin I levels for patient B were within normal range. Patient A had a rapid progression of multi-organ system failure leading to her death within 24 hours from presentation on maximal inopressor support. Patient B, however...Continue Reading

References

Mar 3, 2020·Clinical Chemistry and Laboratory Medicine : CCLM·Giuseppe Lippi, Mario Plebani
Mar 29, 2020·JAMA Cardiology·Riccardo M InciardiMarco Metra
Apr 1, 2020·European Heart Journal·Alina HuaJonathan Byrne
Apr 2, 2020·Diabetes/metabolism Research and Reviews·Weina GuoDesheng Hu
Apr 8, 2020·Circulation Research·Akbarshakh Akhmerov, Eduardo Marban
Apr 21, 2020·Journal of the American College of Cardiology·Behnood BikdeliUNKNOWN Global COVID-19 Thrombosis Collaborative Group, Endorsed by the ISTH, NATF, ESVM, and the IUA, Supported by the ESC Working
Apr 25, 2020·JACC. Case Reports·Mohammed F DabbaghMir B Basir

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