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Unique Patterns of Cardiovascular Involvement in COVID-19

Hendren NS, Grodin JL, Drazner MH. Journal of Cardiac Failure (2020).  doi: https://doi.org/10.1016/j.cardfail.2020.05.006

Key Points:

  • The authors describe an acute COVID-19 cardiovascular syndrome, termed ACovCS reflecting the cardiovascular and thromboembolic complications.
  • These complications include:
    • Acute coronary syndrome with coronary obstructive disease (CAD)
    • Acute myocardial injury without CAD
    • Heart failure
    • Cardiogenic Shock
    • Myocarditis
    • Plus – Arrhythmias, pericardial effusions, cardiac tamponade
  • Thrombotic complications include stroke, pulmonary embolism and deep vein thrombosis.
  • Cardiovascular Presentations can infrequently be isolated but more commonly occurs in conjunction with typical pulmonary disease
  • Distinguishing the groups can be a challenge but markers such as troponin can be helpful as to true cardiac vs. a primary pulmonary presentation.
  • For patients with predominant cardiac disease shock is likely cardiac as opposed to predominant Pulmonary cases where the shock may be more likely septic.
  • Multiple clinical, genetic, environmental and social factors determine the risk of as well as the severity of infection.
  • Categorization by this format should allow an effective diagnosis, treatment, and future research.