‘COVID-19 pandemic’ anxiety-induced Takotsubo cardiomyopathy

Chadha, Sameer

doi:10.1093/qjmed/hcaa135

Cited by 29 publications

(30 citation statements)

References 4 publications

(4 reference statements)

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“…Takotsubo cardiomyopathy, a reversible condition, occurs due to physical and emotional stress that affects the left ventricle. Several reports have shown Takotsubo cardiomyopathy in COVID-19 patients (180)(181)(182)(183)(184)(185). Correspondingly, this condition is also reported in influenza-infected patients (186)(187)(188)(189).…”

Section: Comparison Of Cardiovascular Conditions Associated With Sarsmentioning

confidence: 73%

Immune Mechanisms in Cardiovascular Diseases Associated With Viral Infection

2020

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Influenza virus infection causes 3-5 million cases of severe illness and 250,000-500,000 deaths worldwide annually. Although pneumonia is the most common complication associated with influenza, there are several reports demonstrating increased risk for cardiovascular diseases. Several clinical case reports, as well as both prospective and retrospective studies, have shown that influenza can trigger cardiovascular events including myocardial infarction (MI), myocarditis, ventricular arrhythmia, and heart failure. A recent study has demonstrated that influenza-infected patients are at highest risk of having MI during the first seven days of diagnosis. Influenza virus infection induces a variety of pro-inflammatory cytokines and chemokines and recruitment of immune cells as part of the host immune response. Understanding the cellular and molecular mechanisms involved in influenza-associated cardiovascular diseases will help to improve treatment plans. This review discusses the direct and indirect effects of influenza virus infection on triggering cardiovascular events. Further, we discussed the similarities and differences in epidemiological and pathogenic mechanisms involved in cardiovascular events associated with coronavirus disease 2019 (COVID-19) compared to influenza infection.

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Section: Comparison Of Cardiovascular Conditions Associated With Sarsmentioning

confidence: 73%

Immune Mechanisms in Cardiovascular Diseases Associated With Viral Infection

2020

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“…An overlapping picture of myocarditis and RTCC has been reported too [ 18 ]. Our patient had typical clinical and echocardiographic features of RTCC [ 13 – 29 ]. We could not perform a full diagnostic work-up due to the severity of COVID-19; hence, we could not definitively exclude other cardiovascular pathologies such as aortic dissection, PE, myocarditis or CAD.…”

Section: Discussionmentioning

confidence: 99%

Reverse takotsubo cardiomyopathy in fulminant COVID-19 associated with cytokine release syndrome and resolution following therapeutic plasma exchange: a case-report

Faqihi

Alharthy

Alshaya

et al. 2020

BMC Cardiovasc Disord

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Background Fulminant (life-threatening) COVID-19 can be associated with acute respiratory failure (ARF), multi-system organ failure and cytokine release syndrome (CRS). We present a rare case of fulminant COVID-19 associated with reverse-takotsubo-cardiomyopathy (RTCC) that improved with therapeutic plasma exchange (TPE). Case presentation A 40 year old previous healthy male presented in the emergency room with 4 days of dry cough, chest pain, myalgias and fatigue. He progressed to ARF requiring high-flow-nasal-cannula (flow: 60 L/minute, fraction of inspired oxygen: 40%). Real-Time-Polymerase-Chain-Reaction (RT-PCR) assay confirmed COVID-19 and chest X-ray showed interstitial infiltrates. Biochemistry suggested CRS: increased C-reactive protein, lactate dehydrogenase, ferritin and interleukin-6. Renal function was normal but lactate levels were elevated. Electrocardiogram demonstrated non-specific changes and troponin-I levels were slightly elevated. Echocardiography revealed left ventricular (LV) basal and midventricular akinesia with apex sparing (LV ejection fraction: 30%) and depressed cardiac output (2.8 L/min) consistent with a rare variant of stress-related cardiomyopathy: RTCC. His ratio of partial arterial pressure of oxygen to fractional inspired concentration of oxygen was < 120. He was admitted to the intensive care unit (ICU) for mechanical ventilation and vasopressors, plus antivirals (lopinavir/ritonavir), and prophylactic anticoagulation. Infusion of milrinone failed to improve his cardiogenic shock (day-1). Thus, rescue TPE was performed using the Spectra Optia™ Apheresis System equipped with the Depuro D2000 Adsorption Cartridge (Terumo BCT Inc., USA) without protective antibodies. Over 5 days he received daily TPE (each lasting 4 hours). His lactate levels, oxygenation, and LV function normalized and he was weaned off vasopressors. His inflammation markers improved, and he was extubated on day-7. RT-PCR was negative on day-17. He was discharged to home isolation in good condition. Conclusion Stress-cardiomyopathy may complicate the course of fulminant COVID-19 with associated CRS. If inotropic therapy fails, TPE without protective antibodies may help rescue the critically ill patient.

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“…COVID-19 pandemic has triggered stress-induced cardiomyopathy, also known as takotsubo cardiomyopathy (TCM) 51,52 . Two cases reporting TCM were seen in elderly females presenting with sudden onset substernal chest pain.…”

Section: Takotsubo Cardiomyopathymentioning

confidence: 99%

A Systematic Review of the Cardiovascular Manifestations and Outcomes in the Setting of Coronavirus-19 Disease

Thakkar

Arora

Kumar

et al. 2020

Preprint

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The impact of coronavirus disease, 2019 (COVID-19), has been profound. Though COVID-19 primarily affects the respiratory system, it has also been associated with a wide range of cardiovascular (CV) manifestations portending extremely poor prognosis. The principal hypothesis for CV involvement is through direct myocardial infection and systemic inflammation. We conducted a systematic review of the current literature to provide a foundation for understanding the CV manifestations and outcomes of COVID-19. PubMed and EMBASE databases were electronically searched from the inception of the databases through April 27th, 2020. A second literature review was conducted to include major trials and guidelines that were published after the initial search but before submission. The inclusion criteria for studies to be eligible were case reports, case series, and observation studies reporting CV outcomes among patients with COVID-19 infection. This review of the current COVID-19 disease and CV outcomes literature revealed a myriad of CV manifestations with potential avenues for treatment and prevention. Future studies are required to understand on a more mechanistic level the effect of COVID-19 on the myocardium and thus provide avenues to improve mortality and morbidity.

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‘COVID-19 pandemic’ anxiety-induced Takotsubo cardiomyopathy

Cited by 29 publications

References 4 publications

Immune Mechanisms in Cardiovascular Diseases Associated With Viral Infection

Immune Mechanisms in Cardiovascular Diseases Associated With Viral Infection

Reverse takotsubo cardiomyopathy in fulminant COVID-19 associated with cytokine release syndrome and resolution following therapeutic plasma exchange: a case-report

A Systematic Review of the Cardiovascular Manifestations and Outcomes in the Setting of Coronavirus-19 Disease

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