scholarly journals COVID-19 and the Cardiovascular System: How the First PostModern Pandemic ‘Weakened’ our Hearts

2020 ◽  
Vol 3 ◽  
pp. e15
Author(s):  
Syeda Tasneem Towhid ◽  
◽  
Nadira Naznin Rakhi ◽  
ASM Shamsul Arefin ◽  
Otun Saha ◽  
...  
Keyword(s):  
Cardiovascular System ◽  
Cardiac Injury ◽  
Age Groups ◽  
Signs And Symptoms ◽  
Holistic Approach ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Cardiovascular Damage ◽  
Preventative Measures ◽  
Life Threatening

The global spread of SARS-CoV-2 with its diverse signs and symptoms manifested in COVID-19 patients across different age groups and geographic locations perplexed the clinicians and public health experts. Emerging variants of SARS-CoV-2 through continuous mutation with a limited arsenal of treatment made the study of viral pathogenesis and factors associated with disease outcomes in a holistic approach inevitable, among which pre-existing cardiovascular complications were found to be significantly associated with adverse outcome of COVID-19. In addition, COVID-19 has already been reported to cause cardiac injury and different cardiovascular complications in patients irrespective of preexisting cardiovascular complications, which highlights the importance of recognizing the complications at the onset, although these arising complications might be an indirect effect of SARS-CoV-2 induced cytokine storm or hypoxia rather the virus itself. Also, the drugs used for the clinical management of the patients may have an impact on the induced cardiac complications. Thus, the effect of SARS-CoV-2 on the cardiovascular system needs to be investigated in order to predict the clinical outcome and to devise a proper treatment strategy. Besides, the interaction of vaccines or therapeutics to be approved with the cardiovascular system needs to be evaluated to avoid confounding effects leading to cardiovascular complications followed by post-approval retraction. However, potential biomarkers (eg. troponin, D-dimers, fibrin) associated with cardiac injury may be potentially useful in predicting life-threatening conditions early enough to save lives. In conclusion, this review summarizes the molecular pathogenesis of cardiovascular damage caused by SARS-CoV-2 in COVID-19 patients, as well as prescribed treatment and preventative measures.

scholarly journals Cardiovascular Health and Risk Management in Cancer Survivors

2020 ◽  
Vol 18 (7.5) ◽  
pp. 1004-1006
Author(s):  
Javid J. Moslehi
Keyword(s):  
Cardiovascular Disease ◽  
Cancer Survivors ◽  
Cardiovascular System ◽  
Cardiovascular Health ◽  
Checkpoint Inhibitors ◽  
Angiogenesis Inhibitors ◽  
Cardiovascular Complications ◽  
Cancer Treatments ◽  
Cardiovascular Damage ◽  
Similar Risk

Cardio-oncology is a growing field, due to several factors. These include the recognition that similar risk factors predispose people to both cardiovascular disease and cancer. In addition, certain cancers affect the heart, and cancer treatments can have short-term and long-lasting deleterious effects on the cardiovascular system. More than 40 years ago, it became evident that anthracyclines and radiation cause heart damage, and since then the list of cancer treatments that can harm the cardiovascular system has grown to include more modern treatments, such as anti-HER2 agents and angiogenesis inhibitors. Most recently, immune checkpoint inhibitors (ICIs) have been added to the list of cancer treatments that cause cardiovascular damage. ICI-associated myocarditis is a relatively rare but fatal complication that develops rapidly after initiating immunotherapy. Oncologists should be aware of the potential cardiovascular complications of cancer treatments, and should assess the cardiovascular health of all patients about to undergo therapy. Cancer survivors should be assessed and advised about prevention and treatment that may be needed to address cardiovascular disease.

scholarly journals Cardiac Magnetic Resonance Imaging in Patients with COVID-19

2020 ◽  
pp. 1-3
Author(s):  
Ali Kemal Erenler ◽  
Ali Kemal Erenler ◽  
Seval Komut ◽  
Ahmet Baydin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Magnetic Resonance Imaging ◽  
Tissue Characterization ◽  
Cardiac Injury ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Resonance Imaging ◽  
Cardiac Damage

In the beginning of December 2019, an outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was determined in Wuhan, Hubei, China. Besides its predominant respiratory system-related symptoms, cardiovascular involvement has also been described in adults with direct and indirect cardiac injury. Pre-existing cardiovascular disease and cardiac risk factors have been shown to increase the risk of cardiac complications of COVID-19 infection. However, it is also known that healthy and asymptomatic COVID-19 survivors suffer cardiac damage-related complications. Cardiac Magnetic Resonance Imaging (CMRI) is known to be the reference non-invasive standard to present cardiac function and tissue characterization. It is recommended as an effective and efficient diagnostic imaging choice to obtain critical information for clinical diagnosis and decision-making. In this article, we sought the usefulness of CMRI in cardiovascular complications related to COVID-19.

Gastrointestinal complications following cardiac surgery

2020 ◽  
Vol 28 (9) ◽  
pp. 621-632
Author(s):  
Cheryl Yan Ting Chor ◽  
Saira Mahmood ◽  
Inayat Hussain Khan ◽  
Manasi Shirke ◽  
Amer Harky
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Preventive Measures ◽  
Signs And Symptoms ◽  
Mortality Rates ◽  
Gastrointestinal Complication ◽  
Gastrointestinal Complications ◽  
Ischemic Bowel ◽  
Preventative Measures ◽  
Life Threatening

Gastrointestinal complications after cardiac surgery may be uncommon but they carry high mortality rates. Incidences range from 0.5% to 5.5%, while mortality rates of such complications vary from 0.3% to 87%. They range from small gastrointestinal bleeds, ileus, and pancreatitis to life-threatening complications such as liver failure and ischemic bowel. Due to the vague and often absence of specific signs and symptoms, diagnosis of a gastrointestinal complication is often late. This article aims to review and summarize the literature concerning gastrointestinal complications after cardiac surgery. We discuss the causes, risk factors, diagnosis, preventative measures, and management of these complications. In general, risk factor identification, preventive measures, early diagnosis, and swift management are the keys to reducing the occurrence of gastrointestinal complications and their associated morbidity and mortality.

scholarly journals Exercise Training and Cardiac Rehabilitation in COVID-19 Patients with Cardiovascular Complications: State of Art

Life ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 259
Author(s):  
Mariaconsiglia Calabrese ◽  
Marina Garofano ◽  
Roberta Palumbo ◽  
Paola Di Pietro ◽  
Carmine Izzo ◽  
...  
Keyword(s):  
Exercise Training ◽  
Cardiac Rehabilitation ◽  
Cardiovascular System ◽  
Patient Monitoring ◽  
Scientific Evidence ◽  
Cardiovascular Complications ◽  
Angiotensin Converting Enzyme 2 ◽  
Coronary Syndrome ◽  
Cardiovascular Damage ◽  
Include Heart Failure

Recent scientific literature has investigated the cardiovascular implications of COVID-19. The mechanisms of cardiovascular damage seem to involve the protein angiotensin-converting enzyme 2 (ACE2), to which severe acute respiratory syndrome (SARS) coronavirus-2 (CoV-2) binds to penetrate cells and other mechanisms, most of which are still under study. Cardiovascular sequelae of COVID-19 include heart failure, cardiomyopathy, acute coronary syndrome, arrhythmias, and venous thromboembolism. This article aims to collect scientific evidence by exploiting PubMed, Scopus, and Pedro databases to highlight the cardiovascular complications of COVID-19 and to define the physiotherapy treatment recommended for these patients. Exercise training (ET), an important part of cardiac rehabilitation, is a powerful tool in physiotherapy, capable of inducing significant changes in the cardiovascular system and functional in the recovery of endothelial dysfunction and for the containment of thromboembolic complications. In conclusion, due to the wide variety of possible exercise programs that can be obtained by combining intensity, duration, and speed in various ways, and by adjusting the program based on continuous patient monitoring, exercise training is well suited to the treatment of post-COVID patients with an impaired cardiovascular system of various degrees.

scholarly journals Cardiovascular Complications of COVID-19 Infection

2021 ◽  
Vol 34 (9) ◽  
pp. 608
Author(s):  
Maria Ana Trêpa ◽  
António Hipólito Reis ◽  
Mario Oliveira
Keyword(s):  
Cardiac Arrhythmias ◽  
Myocardial Injury ◽  
Clinical Presentation ◽  
Cardiac Injury ◽  
Cardiovascular Complications ◽  
Adverse Outcomes ◽  
Cardiac Complications ◽  
Usual Practice ◽  
Coronary Syndromes ◽  
Worse Prognosis

Introduction: Reports of cardiovascular complications related to the COVID-19 infection have been frequent.Methods: Narrative review for relevant articles on the topic. The classic cardiovascular risk factors, like age, obesity, diabetes, and hypertension are associated with adverse outcomes in COVID-19 patients. Cardiovascular complications can have a diverse clinical presentation including silent myocardial injury, acute coronary syndromes, thromboembolism, cardiac arrhythmias, and heart failure. There are multiple mechanisms of cardiac injury that are not mutually exclusive. The approach to diagnosis and management should be carried out according to usual practice, while considering the particularities of COVID-19 infection.Conclusion: The interaction between SARS-CoV-2 and the heart is complex and is manifested in multiple ways. Regardless of the clinical presentation, cardiac complications convey a worse prognosis. Patients should be actively monitored and treated accordingly.

scholarly journals Acute cardiac injury in patients with COVID-19

2020 ◽  
Author(s):  
Andrea De Lorenzo ◽  
Daniel Kasal ◽  
Bernardo Tura ◽  
Cristiane Lamas ◽  
Helena Rey
Keyword(s):  
Systematic Review ◽  
Myocardial Injury ◽  
Meta Analysis ◽  
Cardiac Injury ◽  
Risk Of Bias ◽  
Cardiac Complications ◽  
Troponin Elevation ◽  
Study Heterogeneity ◽  
Life Threatening

Introduction: Cardiac complications of COVID-19 are potentially life-threatening. The occurrence of myocardial injury in the context of COVID-19 is multifactorial and has generated increasing interest. Methods: A systematic review with meta-analysis of the literature was performed. MEDLINE and EMBASE were searched. Two independente reviewers evaluated the selected manuscripts for the outcome myocardial injury, defined by troponin elevation above the 99th percentile. Study heterogeneity and risk of bias were evaluated. Results: Eight studies, with a total of 1229 patients, were included. The frequency of myocardial injury was 16% (95% CI: 9% - 27%). The heterogeneity among studies was high (93%). Conclusions: Myocardial injury may occur in patients with COVID-19, with a frequency of 16% among current studies. Continuous research is needed to update these findings, as the pandemic evolves, and to define the implications of myocardial injury in the context of this infection.

scholarly journals A Review of PMMA Bone Cement and Intra-Cardiac Embolism

2016 ◽  
Author(s):  
Puneeth Shridhar ◽  
Yanfei Chen ◽  
Ramzi Khalil ◽  
Anton Plakseyhuk ◽  
Sung Kwon Cho ◽  
...  
Keyword(s):  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Cardiac Injury ◽  
Cement Leakage ◽  
Orthopedic Procedures ◽  
Cardiac Complications ◽  
Vertebral Compression Fractures ◽  
Mechanical Stabilization ◽  
Pmma Bone Cement ◽  
Life Threatening

Percutaneous vertebroplasty procedure is of major importance, given the significant increasing aging population and higher number of orthopedic procedures related to vertebral compression fractures. Vertebroplasty is a complex technique involving injection of polymethylmethacrylate (PMMA) into the compressed vertebral body for mechanical stabilization of the fracture. Our understanding and ability to modify these mechanisms through alterations in cement material is rapidly evolving. However, the rate of cardiac complications secondary to PMMA injection and subsequent cement leakage has increased with time. The following review considers the main features of PMMA bone cement on the heart, and the extent of influence of materials on cardiac embolism. Clinically, cement leakage results in life-threatening cardiac injury. The convolution of this outcome through an appropriate balance of complex material properties is highlighted via clinical case report.

Abstract 16929: Right Heart Strain on Presenting 12-Lead Electrocardiogram Predicts Critical Illness in COVID-19

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mohamad Raad ◽  
Sachin Parikh ◽  
Gurjit Singh
Keyword(s):  
Respiratory Failure ◽  
Cardiac Injury ◽  
Cost Effective ◽  
Cardiovascular Complications ◽  
Cor Pulmonale ◽  
Right Heart ◽  
Institutional Review ◽  
Life Threatening ◽  
Clinical Tools ◽  
Almost All

Introduction: The world has been facing the COVID-19 pandemic. Primarily a pulmonary illness, most deaths have been caused by respiratory failure. Emerging information has revealed that cardiovascular complications, including cardiac injury and cor pulmonale, can also be life-threatening consequences of COVID-19. Hypothesis: Signs of right heart strain on presenting 12-lead ECG predicts mortality in patients admitted with COVID-19. Methods: We retrospectively evaluated 480 patients consecutively admitted with COVID-19. ECGs from the emergency department (ED) were read by G.S. and S.P. who were blinded to data and outcomes. Right heart strain (RHS) was defined by any new right axis deviation, S1Q3T3 pattern, incomplete or complete right bundle branch block, or ST Depressions with T-wave inversions in leads V1-3 or II, III, aVF. This study was approved by the Institutional Review Board (IRB# 13774). Results: ECGs from the ED were available for 314 patients who were included in the analysis. Almost all patients were in sinus rhythm with sinus tachycardia being the most frequent dysrhythmia. RHS findings were present in 12.7% of cases. RHS was significantly associated with mortality and was the strongest predictor even after multivariate regression for mortality [OR 18.3 (6.1-55.3), p<0.001] (figure 1, table 1). Conclusions: Among available clinical tools, ECGs are easily performed, cost-effective, and widely available. Patients with evidence of RHS on initial ECG had significantly higher rates of mortality which has not been previously reported. Given that respiratory failure is the most common cause of death in patients with COVID-19, this information is valuable.

Abstract 15097: Covid-19 and Cardiovascular Complications: Pooled Analysis of Observational Studies

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Vikramaditya Reddy Samala Venkata ◽  
Rahul Gupta ◽  
Surya Kiran Aedma ◽  
Bruce W Andrus
Keyword(s):  
Heart Failure ◽  
Cardiac Injury ◽  
Cardiovascular Complications ◽  
Pooled Analysis ◽  
Community Acquired Pneumonia ◽  
Cardiac Complications ◽  
Elevated Troponin ◽  
Troponin Elevation ◽  
Icu Admission ◽  
Coronary Syndrome

Introduction: The pandemic of COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection. Studies published so far raise concerns for cardiac complications in the infected individuals.The aim of our study is to determine the prevalence of cardiac complications in COVID-19. Methods: A systematic electronic search was performed in PubMed, Embase, Google Scholar. Retrospective studies having original hospitalized patient data were included in our study; while studies focussed only on intensive care unit (ICU) patients were excluded to prevent selection bias. Pooled analysis using a random effects model (Mantel-Haenszel test) was performed to look at the incidence of troponin elevation and association between elevated troponin levels, admission to the ICU and associated mortality. Results: 18 studies from 6 countries with over 9,500 patients were included in our analysis. Troponin elevation was reported in 16% (1123/7130) of patients. Heart failure was reported in 1 study and cardiac arrhythmia was reported in 2 studies. Elevated troponin levels were associated with higher rates of ICU admission (OR 26.17, 7.06-96.94; p<0.01) and mortality (OR 27.22, 10.24-72.33; P<0.01) (Figure 1). Information regarding the degree of troponin elevation and etiology associated with it (myocarditis vs acute coronary syndrome vs stress induced from critical illness) was not reported. Conclusion: Heart failure was reported in around 20% of the patients in 1 study, while troponin elevation was seen in 16% of the patients in 10 different studies. This is similar to the rate of cardiac complications reported in severe community acquired pneumonia. Troponin elevation in itself was associated with higher rates of ICU admission and mortality. This should alert the clinicians to check for troponin levels in these patients and triage them accordingly. More studies are needed to better understand specific mechanisms of cardiac injury in COVID-19 patients.

scholarly journals Role of advanced imaging in COVID-19 cardiovascular complications

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Federica Catapano ◽  
Livia Marchitelli ◽  
Giulia Cundari ◽  
Francesco Cilia ◽  
Giuseppe Mancuso ◽  
...  
Keyword(s):  
Multimodality Imaging ◽  
Cardiac Injury ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Advanced Imaging ◽  
Cardiovascular Involvement ◽  
Diagnostic Delays

AbstractClinical manifestations of COVID-19 patients are dominated by respiratory symptoms, but cardiac complications are commonly observed and associated with increased morbidity and mortality. Underlying pathological mechanisms of cardiac injury are still not entirely elucidated, likely depending on a combination of direct viral damage with an uncontrolled immune activation. Cardiac involvement in these patients ranges from a subtle myocardial injury to cardiogenic shock. Advanced cardiac imaging plays a key role in discriminating the broad spectrum of differential diagnoses. Present article aims to review the value of advanced multimodality imaging in patients with suspected SARS-CoV-2-related cardiovascular involvement and its essential role in risk stratification and tailored treatment strategies. Based on our experience, we also sought to suggest possible diagnostic algorithms for the rationale utilization of advanced imaging tools, such as cardiac CT and CMR, avoiding unnecessary examinations and diagnostic delays.

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