Practical Approach to Acute Coronary Syndrome in Patients with COVID-19
Int. j. cardiovasc. sci. (Impr.)
;
34(1): 89-98, Jan.-Feb. 2021. tab, graf
Article
in English
| LILACS
| ID: biblio-1154528
ABSTRACT
Abstract Acute cardiac injury is associated with higher mortality in patients with the novel coronavirus disease-2019 (COVID-19) and the exact etiology can be challenging to diagnose in the emergency setting during the pandemic. From a pathophysiological perspective, SARS-CoV-2 infection is characterized by an overproduction of inflammatory cytokines (IL-6, TNF-alpha) that leads to systemic inflammation and consequent increased risk of acute myocardial infarction (AMI) caused by atheromatous plaque rupture and significant myocardial oxygen supply-demand imbalance. Moreover, SARS-CoV-2 tropism to the renin-angiotensin-aldosterone system through the ACE2 receptor induces myocarditis that may rapidly progress to left ventricular dysfunction and hemodynamic instability. Myocardial inflammation with pericardial involvement, i.e. , myopericarditis, can progress to cardiac tamponade and obstructive shock. These cardiovascular complications, which are associated with a worse prognosis and higher mortality, can be associated with clinical manifestations, electrocardiographic changes, and troponin values similar to AMI. Thus, the diagnosis and treatment of patients with acute chest pain and dyspnea admitted to the emergency department is a significant challenge during the COVID-19 pandemic. Here, we provide a review of the literature focusing on a practical approach to acute coronary syndrome patients with confirmed or suspected COVID-19.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Electrocardiography
/
Acute Coronary Syndrome
/
COVID-19
/
Myocardial Infarction
Type of study:
Etiology study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Int. j. cardiovasc. sci. (Impr.)
Journal subject:
Cardiology
Year:
2021
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade Estácio de Sá/BR
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