Pulmonary thromboembolism with multiple right heart mural thrombus in a patient with COVID-19

Dehghan, Habiboallah; Soleimani, Azam

doi:10.1007/s12574-020-00500-x

Cited by 4 publications

(5 citation statements)

References 4 publications

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“…Data from literature on RHT in COVID-19 patients is infrequent and mainly relates to case reports. The majority of them reported successful treatment with low-weight heparin in hemodynamically stable patients with COVID-19 and RHT [ 31 , 32 , 34 , 36 , 44 ], but there are also reports of more severe cases. Carrizales-Sepúlveda et al [ 33 ] reported a case of a 62-year-old male who was diagnosed with circulatory shock and RHT on the 13th day of his COVID-19 infection; he was subsequently treated with alteplase.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Alteplase on Mortality in Critically Ill Patients with COVID-19 and Pulmonary Embolism

Oliynyk,

Rorat,

Solyarik

et al. 2023

Viruses

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COVID-19 is an independent risk factor for pulmonary embolism (PE). Little is known about alteplase therapy in this patient group. A retrospective study analyzed 74 patients with PE and acute respiratory distress syndrome (ARDS) due to COVID-19 who were hospitalized in the intensive care unit in 2021. Patients with or without confirmed right heart thrombi (RHT) were treated with unfractionated heparin or alteplase. The mortality rate in patients with RHT treated with heparin was 100% compared to 37.9% and 55.2% in those treated with alteplase without RHT and alteplase with RHT, respectively. The risk of death in the alteplase group increased with delayed thrombolysis (p = 0.009, odds ratio (OR) = 1.73 95% CI (confidence interval) 1.14–2.62), increased D-dimer concentration (p = 0.02, OR = 1.43 95% CI 1.06–1.93), and decreased PaO2/FiO2 ratio (p = 0.001, OR = 0.56 95% CI 0.41–0.78). The receiver operating characteristic method determined that a 1-day delay in thrombolytic treatment, D-dimer concentration >5.844 mg/L, and PaO2/FiO2 <144 mmHg predicted a fatal outcome. The risk of death in patients with severe COVID-19 with ARDS and PE increases with higher D-dimer levels, decreased PaO2/FiO2, and delayed thrombolytic treatment. Thrombolysis seems to be treatment of choice in severe COVID-19 with PE and RHT. It should be carried out as soon as possible after the diagnosis is established.

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Section: Discussionmentioning

confidence: 99%

“…The literature only includes infrequent case studies with a variety of therapeutic attempts (including i.v. heparin, LMWH, warfarin, and alteplase) and diverse clinical effects [ 31 , 32 , 33 , 34 , 35 , 36 ]. Consequently, the prevalence and mortality rate in patients with severe COVID-19 and RHT remain unknown.…”

Section: Introductionmentioning

confidence: 99%

Impact of Alteplase on Mortality in Critically Ill Patients with COVID-19 and Pulmonary Embolism

Oliynyk,

Rorat,

Solyarik

et al. 2023

Viruses

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“…Researchers observed that SARS-CoV-2 could result in a spectrum of cardiovascular diseases, including thromboembolism, arrhythmia, myocarditis, and acute coronary syndrome [ 89 , 90 , 91 ]. The cardiac injury caused by COVID-19 results from cytokine storm, viral myocarditis, and ischemia [ 89 , 90 , 92 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac magnetic resonance (CMR) studies illustrated the indications of myocardial inflammation, fibrosis, left ventricle (LV) enlargement, and biventricular involvement in COVID-19 [ 93 , 94 , 95 ]. Similarly, normal pregnancy has multiple cardiovascular effects, including increased heart rate, cardiac output, and vascular volume; dyspnea on exertion; ejection murmurs over the pulmonary artery and aorta; and decreased venous return to the heart, which may lead to a presyncope condition [ 89 , 90 , 91 , 96 , 97 , 98 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Complications of COVID-19 among Pregnant Women and Their Fetuses: A Systematic Review

Yaghoobpoor

Fathi

Vakili

et al. 2022

JCM

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Background: COVID-19 is a viral infectious disease leading to a spectrum of clinical complications, especially cardiovascular. Evidence shows that this infection can potentially accompany a worse outcome in pregnant women. Cardiovascular complications in mothers and their fetuses are reported by previous studies. Objective: In this systematic review, we aim to investigate the cardiovascular complications of COVID-19 during pregnancy in the mothers and fetus, according to the published literature. Method: We systematically searched the online databases of PubMed, Scopus, Web of Science, and Google Scholar, using relevant keywords up to April 2022. We included all observational studies reporting cardiovascular complications among COVID-19-affected pregnant women and their fetuses. Results: We included 74 studies containing 47582 pregnant COVID-19 cases. Pre-eclampsia, hypertensive disorders, cardiomyopathy, heart failure, myocardial infarction, thrombosis formation, alterations in maternal–fetal Doppler patterns, and maternal and fetal arrhythmia were reported as cardiovascular complications. The highest incidences of pre-eclampsia/eclampsia among COVID-19 pregnant cases, reported by studies, were 69% and 62%, and the lowest were 0.5% and 3%. The highest and lowest incidences of fetal bradycardia were 20% and 3%, and regarding fetal tachycardia, 5.4% and 1%, respectively. Conclusion: SARS-CoV-2 infection during pregnancy can potentially be associated with cardiovascular complications in the mother, particularly pre-eclampsia and heart failure. Moreover, SARS-CoV-2 infection during pregnancy can potentially cause cardiovascular complications in the fetus, particularly arrhythmia.

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“…Thrombosis and COVID-19: Hypercoagulation conditions due to systemic inflammation, stability secondary to moderate to critical disease, lung endothelial injury also hypoxemia are suggested as the main mechanisms for pulmonary thromboembolism and thrombus formation in cardiac chambers. 43,44 Ischemic coronary damage after thrombus formation in coronary arterial bed in hypoxemic subjects is accountable for myocardial infarction and unbalanced coronary syndromes in the COVID period that can result in cardiac arrhythmia and ventricular dysfunction. 45 Myocardial ischemia, side effects of drugs, underlying myocarditis and, electrolytes abnormalities have been suggested as the fundamental mechanism for cardiac arrhythmias.…”

Section: Coagulation Abnormalities and Thrombosismentioning

confidence: 99%

A Survey on Cardiac Complications of COVID-19 in Infants

Bahrami¹,

Ekraminasab²,

Asadian³

2021

WJPN

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Congenital heart disease (CHD) may have serious effects on the course of COVID-19. Limited data were available on CHD in neonates with COVID-19. This study aimed to review the cardiac complications in neonates infected with COVID-19. Some studies showed that myocardial injury in adult patients is often correlated with a fatal outcome. But, scientific evidence in infants is rare, although several reports were published with the description of cardiac involvement in COVID-19 pediatric patients. In these young subjects, a background of surgically treated CHD seems to be a predisposing factor. Numerous studies showed Multisystem inflammatory syndrome in children (MIS-c) is a deadly demonstration of COVID-19 with cardiac involvement. The underlying pathophysiology of COVID-19-associated cardiovascular complications is not fully understood, although direct viral infection of the myocardium, systemic inflammatory response, coagulation abnormalities and thrombosis and hypoxia have been suggested as possible mechanisms of cardiac complications. It seems COVID-19 can affect different parts of the heart; however, the myocardium is more involved. The mechanisms of pathogenesis of cardiovascular implications in adults and infants are similar but CHD and MIS-c in infants are more important. Further studies on the effects of COVID-19 on the neonatal cardiovascular system are needed.

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Pulmonary thromboembolism with multiple right heart mural thrombus in a patient with COVID-19

Cited by 4 publications

References 4 publications

Impact of Alteplase on Mortality in Critically Ill Patients with COVID-19 and Pulmonary Embolism

Impact of Alteplase on Mortality in Critically Ill Patients with COVID-19 and Pulmonary Embolism

Cardiovascular Complications of COVID-19 among Pregnant Women and Their Fetuses: A Systematic Review

A Survey on Cardiac Complications of COVID-19 in Infants

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