Introduction: The 2019 coronavirus, known as SARS-CoV-2 and COVID-19, was named a pandemic by the WHO in March 2020. It binds to the ACE-2 receptor and transmembrane serine protease 2 and is highly virulent. There are many sequelae of this virus, including neurological consequences. We have performed a literature review of the neurological sequelae of COVID-19 with relation to neuroimaging and then present a case series. Case Series: Seven cases were seen by neurology consultants at the Hospital for Special Surgery in New York City between February and May of 2020; 5 met criteria. The majority of these consultations were called for encephalopathy. Some had neuroimaging of brain MRI or head CT, which all showed microvascular disease. One case had prior imaging without microvascular disease. Summary/Conclusion: It is known that vascular disease is a risk factor for severe COVID-19 infection. This case series demonstrates presence of microvascular disease in patients with encephalopathy. We know that microvascular disease can be a risk factor for toxic metabolic encephalopathy. It is unclear if the microvascular disease was present prior to infection, although at least one patient had prior imaging without microvascular disease. More research is needed to determine if COVID-19 infection can cause vascular disease.

No abstract

Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.

No abstract

BACKGROUND The natural history, management, and outcome of takotsubo (stress) cardiomyopathy are incompletely understood. METHODS The International Takotsubo Registry, a consortium of 26 centers in Europe and the United States, was established to investigate clinical features, prognostic predictors, and outcome of takotsubo cardiomyopathy. Patients were compared with age-and sex-matched patients who had an acute coronary syndrome. RESULTS Of 1750 patients with takotsubo cardiomyopathy, 89.8% were women (mean age, 66.8 years). Emotional triggers were not as common as physical triggers (27.7% vs. 36.0%), and 28.5% of patients had no evident trigger. Among patients with takotsubo cardiomyopathy, as compared with an acute coronary syndrome, rates of neurologic or psychiatric disorders were higher (55.8% vs. 25.7%) and the mean left ventricular ejection fraction was markedly lower (40.7±11.2% vs. 51.5±12.3%) (P<0.001 for both comparisons). Rates of severe in-hospital complications including shock and death were similar in the two groups (P=0.93). Physical triggers, acute neurologic or psychiatric diseases, high troponin levels, and a low ejection fraction on admission were independent predictors for in-hospital complications. During long-term follow-up, the rate of major adverse cardiac and cerebrovascular events was 9.9% per patient-year, and the rate of death was 5.6% per patient-year. CONCLUSIONS Patients with takotsubo cardiomyopathy had a higher prevalence of neurologic or psychiatric disorders than did those with an acute coronary syndrome. This condition represents an acute heart failure syndrome with substantial morbidity and mortality. (Funded by the Mach-Gaensslen Foundation and others; ClinicalTrials.gov number, NCT01947621.).

No abstract

The content of these European Society of Cardiology (ESC) Guidelines has been published for personal and educational use only. No commercial use is authorized. No part of the ESC Guidelines may be translated or reproduced in any form without written permission from the ESC. Permission can be obtained upon submission of a written request to Oxford University Press, the publisher of the European Heart Journal and the party authorized to handle such permissions on behalf of the ESC. Disclaimer. The ESC Guidelines represent the views of the ESC and were arrived at after careful consideration of the available evidence at the time they were written. Health professionals are encouraged to take them fully into account when exercising their clinical judgement. The guidelines do not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patients, in consultation with that patient, and where appropriate and necessary the patient's guardian or carer. It is also the health professional's responsibility to verify the rules and regulations applicable to drugs and devices at the time of prescription.

The disclosure forms of all experts involved in the development of these Guidelines are available on the ESC website www.escardio.org/guidelines.