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The Management of Acute Onset Complete Heart Block and Atrial Flutter in a Patient with COVID-19
Coronavirus disease (COVID-19) has infected millions of people worldwide. Its cardiac presentations include myocarditis, arrhythmias and structural heart changes even in young and healthy individuals. The long-term sequelae of these manifestations are unknown. We describe a unique combination of com...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SMC Media Srl
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8900571/ https://www.ncbi.nlm.nih.gov/pubmed/35265539 http://dx.doi.org/10.12890/2022_003026 |
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author | Hussain, Murtaza Awuah, Dominic Deliwala, Smit Alkotob, Mohammed Luay Seedahmed, Elfateh Bachuwa, Ghassan |
author_facet | Hussain, Murtaza Awuah, Dominic Deliwala, Smit Alkotob, Mohammed Luay Seedahmed, Elfateh Bachuwa, Ghassan |
author_sort | Hussain, Murtaza |
collection | PubMed |
description | Coronavirus disease (COVID-19) has infected millions of people worldwide. Its cardiac presentations include myocarditis, arrhythmias and structural heart changes even in young and healthy individuals. The long-term sequelae of these manifestations are unknown. We describe a unique combination of complete heart block and atrial flutter in the setting of COVID-19. SARS-CoV-2 virulence mechanisms can cause fibrosis in the myocardium resulting in loss of sinus node dominance. The paradoxical finding of atrial flutter and complete heart block is very rare. Prompt cardiac evaluation and electrophysiological testing are important. Cardiac magnetic resonance imaging (cMRI) and endomyocardial biopsies are the gold standard investigations. Anticoagulation should be administered until atrioventricular synchrony is achieved. LEARNING POINTS: Simultaneous atrial flutter and third-degree atrioventricular block (AVB) caused by COVID-19 infection should be treated with a pacemaker according to heart block guidelines. During the COVID-19 pandemic, we recommend leadless pacemaker implantation for third-degree AVB as it has a lower risk of infection compared with traditional percutaneous procedures. Due to a lack of long-term data, patients with cardiac manifestations from COVID-19 require close follow-up with individualized surveillance schedules. |
format | Online Article Text |
id | pubmed-8900571 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SMC Media Srl |
record_format | MEDLINE/PubMed |
spelling | pubmed-89005712022-03-08 The Management of Acute Onset Complete Heart Block and Atrial Flutter in a Patient with COVID-19 Hussain, Murtaza Awuah, Dominic Deliwala, Smit Alkotob, Mohammed Luay Seedahmed, Elfateh Bachuwa, Ghassan Eur J Case Rep Intern Med Articles Coronavirus disease (COVID-19) has infected millions of people worldwide. Its cardiac presentations include myocarditis, arrhythmias and structural heart changes even in young and healthy individuals. The long-term sequelae of these manifestations are unknown. We describe a unique combination of complete heart block and atrial flutter in the setting of COVID-19. SARS-CoV-2 virulence mechanisms can cause fibrosis in the myocardium resulting in loss of sinus node dominance. The paradoxical finding of atrial flutter and complete heart block is very rare. Prompt cardiac evaluation and electrophysiological testing are important. Cardiac magnetic resonance imaging (cMRI) and endomyocardial biopsies are the gold standard investigations. Anticoagulation should be administered until atrioventricular synchrony is achieved. LEARNING POINTS: Simultaneous atrial flutter and third-degree atrioventricular block (AVB) caused by COVID-19 infection should be treated with a pacemaker according to heart block guidelines. During the COVID-19 pandemic, we recommend leadless pacemaker implantation for third-degree AVB as it has a lower risk of infection compared with traditional percutaneous procedures. Due to a lack of long-term data, patients with cardiac manifestations from COVID-19 require close follow-up with individualized surveillance schedules. SMC Media Srl 2022-02-23 /pmc/articles/PMC8900571/ /pubmed/35265539 http://dx.doi.org/10.12890/2022_003026 Text en © EFIM 2022 This article is licensed under a Commons Attribution Non-Commercial 4.0 License |
spellingShingle | Articles Hussain, Murtaza Awuah, Dominic Deliwala, Smit Alkotob, Mohammed Luay Seedahmed, Elfateh Bachuwa, Ghassan The Management of Acute Onset Complete Heart Block and Atrial Flutter in a Patient with COVID-19 |
title | The Management of Acute Onset Complete Heart Block and Atrial Flutter in a Patient with COVID-19 |
title_full | The Management of Acute Onset Complete Heart Block and Atrial Flutter in a Patient with COVID-19 |
title_fullStr | The Management of Acute Onset Complete Heart Block and Atrial Flutter in a Patient with COVID-19 |
title_full_unstemmed | The Management of Acute Onset Complete Heart Block and Atrial Flutter in a Patient with COVID-19 |
title_short | The Management of Acute Onset Complete Heart Block and Atrial Flutter in a Patient with COVID-19 |
title_sort | management of acute onset complete heart block and atrial flutter in a patient with covid-19 |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8900571/ https://www.ncbi.nlm.nih.gov/pubmed/35265539 http://dx.doi.org/10.12890/2022_003026 |
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