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-Flowchart of the clinical approach to patients with chest pain during the coronavirus disease-2019 (COVID-19) pandemic COVID-19: coronavirus disease-2019; STEMI: acute ST-elevation myocardial infarction; NSTEMI: acute non-ST-elevation myocardial infarction; PCI: percutaneous coronary intervention.
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Acute cardiac injury is associated with higher mortality in patients with the novel coronavirus disease-2019 (COVID-19) and the exact etiology can be challenging to diagnose in the emergency setting during the pandemic. From a pathophysiological perspective, SARS-CoV-2 infection is characterized by an overproduction of inflammatory cytokines (IL-6,...
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... Moreover, in the most severe forms of COVID-19, there are cardiovascular complications such as myocarditis, acute myocardial infarction, and right ventricular overload due to severe pulmonary involvement. 33,41,51 Thus, clinical reasoning is based on clinical assessment, appropriate propaedeutic, risk stratification, and complementary diagnostic exams (ECG, cardiac enzymes, and bedside echocardiography) (Figure 1), taking into consideration that a diagnostic error in this context has a strong iatrogenic effect regarding the patient -due to the risks of an unnecessary procedure -and the healthcare team -due to the exposure to a potential infection without the appropriate protection and caution. 37 Several scientific societies and institutions have positioned themselves on the relocation of the scarce medical supplies in face of the increased demand for hospital care and adjustments in the management of acute coronary syndrome during the COVID-19 pandemic. ...
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Background:
Acute coronary syndrome (ACS) is a critical disease encountered in the emergency department (ED). Despite the development of diagnostic tools, it may be difficult to diagnose ACS because of atypical symptoms and equivocal test results. We investigated the difference in the rates of revisit and undetected ACS between adult and elderly p...
Citations
... The suspicion of focal myocarditis is raised in the presence of chest pain after a syndrome that is similar to influenza, thus presenting clinical evidence that points to an ACS for ECG or laboratory tests, or even with the presentation of cardiac wall movement abnormalities, but without evidence of an obstructive coronary artery disease for coronary angiography. 2,5,11,46,[48][49][50][51][52] The mechanisms and manifestations of cardiac arrhythmia are variable and include supraventricular tachycardia, polymorphic ventricular tachycardia, and torsade. However, the etiology of these abnormalities is still unclear. ...
... They may come from the disease itself through the inflammatory cascade, myocarditis, and hypoxia, or from the therapies based on chloroquine, hydroxychloroquine, moxifloxacin, and azithromycin. [47][48][49] In our study, the use of these medications was reported in 54.5% of the studies in which there was cardiac involvement after diagnosis of COVID-19. [26][27][28][29]33,[35][36][37][41][42][43][44] Acute respiratory infection caused by SARS-CoV-2 may be linked to an increased risk for classic myocardial infarction, as it is already known that inflammatory responses in the endothelium, such as that occurring in COVID-19, can increase the occurrence of plaque rupture. ...
... One of the possible factors indicated in previous studies as related to ECG alterations would be due to the effect of antivirals used. 49,52,[57][58][59] Thakore et al. 57 observed the relevance of QT interval (period of the ECG from the beginning of the Q wave to the end of the T wave) analysis among patients infected with COVID-19. In this retrospective study, it was observed that an increase of 10 ms in corrected QT interval was related to a 16% increase in the patient's chance of having a higher severity index and, therefore, a higher risk of fatal evolution, given that, among patients who died during hospitalizations, a significant portion had a longer corrected QT interval on baseline ECG. ...
... A general practitioner in a primary care must be able to distinguish such things by taking a detailed current medical and past history. 10 In establishing a working diagnosis, one must evaluate the location, quality, duration, mitigating and exacerbation factors of the chest pain. 11 Chest compressions with dyspnea suggest acute coronary syndromes (myocardial infarction, unstable angina), pulmonary embolism or pain of the chest wall. ...
A common complaint with a wide range of differential diagnoses is chest pain. A non-life-threatening and life-threatening can cause chest pain. Before considering more benign causes, the first step is to focus on ruling out serious medical conditions. Visceral pain is generally described as dull, deep, throbbing, and oppressive but can also be referred elsewhere. Chest pain due to an ischemic heart disease is described as radiating chest pain from the left or right shoulder, jaw, or left arm. This review describes the different types of chest pain that play an important role in ruling out cardiac and non-cardiac chest pain, which is then essential for proper management.
... Because of the affinity of corona virus to ACE 2 receptors and its effect on rennin angiotensin aldosterone system it can produce myocarditis and can lead to left ventricular dysfunction, myocardial inflammation and pericardial involvement and finally haemodynamic instability. 9 Worldometer statistics reveals that there are a total of 105 million cases in the world and 2.3 million deaths. ...
We have studied the pattern of COVID-19 epidemic in Andhra Pradesh and compared with other high burden states in India utilizing Government of India statistics. We have compared the Indian figures with the statistics in other countries.
We have analyzed the data published by Ministry of Health and family Welfare Government of India, Government of Andhra Pradesh and WHO statistics as well as worldometer statistics. We have studied the hospital statistics of our tertiary care COVID center and analyzed the results.
The statistics revealed highest number of cases are seen in United States of America with case fatality rate of 1.74%.Mexico has highest case fatality rate of 8.5%. Italy has 3.5% and United Kingdom 2.8%.In India Maharashtra has highest number of COVID-19 casualties with case fatality of 2.52%. Indian national average of case fatality is 1.47%. Andhra Pradesh has a case fatality of 0.80%. In Andhra Pradesh the pandemic of COVID-19 peaked in the months of August and September both in terms of number of cases and deaths and then decline started. Hospital based records showed a death rate of 3.92%.
... Considerable clinical and experimental evidence shows that hypertension is very significant in the diabetic heart disease pathogenesis [21][22] . CAD is verycommunalamong patients with diabetes and hypertension as compared to theindividuals with diabetes mellitus or hypertension only, and the progress of atherosclerosis is accelerated with greater fragmentation of atherosclerotic plaques and a low coronary perfusion reserve in diabetic patients along with hypertension. ...
Aim: To compare the incidence of in-hospital complications between diabetic normotensive and hypertensive diabetic patients presenting with acute myocardial infarction (MI) Methodology: This observational cohort study was conducted at National Institute of Cardiovascular Diseases Karachi from May 2019 to April 2020. We examined 220 diabetics with acute MI were included. 50% of the patients had high blood pressure and the rest had normal blood pressure. After enrollment in the study, selectees were observed for acute myocardial infarction complications in the hospital. Results: Most of the baseline characteristics were similar in both groups of patients. However, the hypertensive patients in the diabetes group had diabetes, high heart rate, and high blood pressure at reporting. The complication rates did not differ statistically between the two groups. The rates of complications occurred between diabetes and normotensive hypertension; Atrial fibrillation (AF) 15.5% vs 12.7% p = 0.194, respectively, ventricular tachycardia (LH) 14.5% vs 13.6%, AV block type-1 8.2% vs 7.3% p = 0.296, type2 AV block 2.7% vs 1.8% p = 0.352, complete heart block 11.8% vs 10% p = 0.313, acute congestive heart failure (CHF) 13.6% VS% 9.1 p = 0.137, left ventricular failure (LVF)19.1% vs 16.4% p = 0.259, cardiogenic shock (CS) 14.5% vs 10.9% p = 0.184, recurrent IM (Re-MI) 14.5% 10.9% p = 0.184 and mortality 14.5% vs 12.7 and% p = 0.326, respectively. Conclusion:It is concluded that diabetic patients with hypertensionhave not elevated risk of complications in the hospital after acute myocardial infarction. Key words: diabetes, hypertension, hospital complications, acute myocardial infarction
... Furthermore, the association between COVID-19 and previous cardiovascular disease is related to worse outcomes and increased risk of death. [3] The damage caused by COVID-19 to the cardiovascular system is probably multifactorial and can result from an imbalance between high metabolic demand and low cardiac reserve, systemic inflammation and thrombogenesis. [4] Initial data suggest that those with COVID-19 and hypertension or cardiovascular disease have a mortality rate of 2 to 3 times higher than the population that is affected by the virus in general, suggesting that they are highly susceptible to the most serious effects of the disease. ...
Objective
To analyze scientific evidence on changes in the myocardial injury marker troponin and clinical outcome in patients hospitalized with COVID-19.
Method
A scoping review was adopted, in the Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online and Virtual Health Library bases, from May to July 2022. Using as descriptors: Troponin; COVID-19; Cardiovascular System.
Results
23 studies revealed cardiac alterations in hospitalized patients with COVID-19 by examining the cardio specific biomarker troponin, in addition to relating it to high mortality rates. Studies have shown a great relationship between acute myocardial injury, evidenced by elevated troponin, and a worse outcome during hospitalization.
Conclusion
Cardiovascular changes were mapped in patients hospitalized with COVID -19 who progressed to severe cases of the disease. This study can contribute to care planning through protocols aimed at clinical management, specific for patients with the disease, both in the acute phase and in the post- COVID -19 phase.
DESCRIPTORS:
Troponin; Cardiovascular System; COVID -19; Nursing.
Objective
To analyze scientific evidence on changes in the myocardial injury marker troponin and clinical outcome in patients hospitalized with COVID-19.
Method
A scoping review was adopted, in the Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online and Virtual Health Library bases, from May to July 2022. Using as descriptors: Troponin; COVID-19; Cardiovascular System.
Results
23 studies revealed cardiac alterations in hospitalized patients with COVID-19 by examining the cardio specific biomarker troponin, in addition to relating it to high mortality rates. Studies have shown a great relationship between acute myocardial injury, evidenced by elevated troponin, and a worse outcome during hospitalization.
Conclusion
Cardiovascular changes were mapped in patients hospitalized with COVID -19 who progressed to severe cases of the disease. This study can contribute to care planning through protocols aimed at clinical management, specific for patients with the disease, both in the acute phase and in the post- COVID -19 phase.
DESCRIPTORS:
Troponin; Cardiovascular System; COVID -19; Nursing.
Objective
To analyze scientific evidence on changes in the myocardial injury marker troponin and clinical outcome in patients hospitalized with COVID-19.
Method
A scoping review was adopted, in the Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online and Virtual Health Library bases, from May to July 2022. Using as descriptors: Troponin; COVID-19; Cardiovascular System.
Results
23 studies revealed cardiac alterations in hospitalized patients with COVID-19 by examining the cardio specific biomarker troponin, in addition to relating it to high mortality rates. Studies have shown a great relationship between acute myocardial injury, evidenced by elevated troponin, and a worse outcome during hospitalization.
Conclusion
Cardiovascular changes were mapped in patients hospitalized with COVID -19 who progressed to severe cases of the disease. This study can contribute to care planning through protocols aimed at clinical management, specific for patients with the disease, both in the acute phase and in the post- COVID -19 phase.
DESCRIPTORS:
Troponin; Cardiovascular System; COVID -19; Nursing.
Diante do cenário pandêmico, a investigação por informações sobre a COVID-19 se torna um estudo crescente em busca de respostas para as possíveis repercussões clínicas da doença, dentre elas, a miocardite. A miocardite é uma patologia de etiologia diversa que, em decorrência de infiltrado no miocárdio, há a liberação de mediadores agressivos ao miócito, provocando a necrose e perda da estrutura miocárdica. A presente revisão tem como objetivo analisar a correlação entre pacientes adultos pós-COVID e miocardite, identificar o perfil dos pacientes adultos acometidos, bem como descrever sua evolução e o tratamento adotado. O estudo é uma revisão bibliográfica sistemática, realizada a partir de um levantamento de trabalhos do período entre 2020 e 2022 através das bases de dados SciELO e PubMed. Foi evidenciado que comorbidades associadas e a idade avançada dos pacientes se mostraram fatores correlacionados com a miocardite pós-COVID. Porém, por ser um tema ainda recente e controverso, percebe-se que os dados disponíveis relacionados à miocardite em pacientes adultos após a infecção por COVID-19 precisam ser aprofundados através de novas pesquisas necessárias para avançar na compreensão da miocardite pós-COVID-19.
