COVID-19-associated heart failure: Difference between revisions

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*: Acute [[renal failure]]
*: Acute [[renal failure]]
*: [[Multiorgan failure]]
*: [[Multiorgan failure]]
* In [[COVID-19]] [[patients]] presence of underlying [[cardiovascular disease]] was associated with poor outcome, and [[case fatality rate]] of [[COVID-19]] [[patients]] with [[cardiovascular comorbidities]] was 10.5%.


==Diagnosis==
==Diagnosis==

Revision as of 06:36, 11 November 2021

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For COVID-19 frequently asked inpatient questions, click here
For COVID-19 frequently asked outpatient questions, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mitra Chitsazan, M.D.[2]Mandana Chitsazan, M.D. [3]

Synonyms and keywords: Novel coronavirus, COVID-19, Wuhan coronavirus, coronavirus disease-19, coronavirus disease 2019, SARS-CoV-2, 2019-nCoV, 2019 novel coronavirus, heart failure, acute heart failure, de Novo acute heart failure, chronic heart failure, acute decompensated heart failure, HFrEF, HFpEF, heart failure with reduced ejection fraction, heart failure with a preserved ejection fraction

Overview

Corona virus disease 2019 COVID-19 caused by a novel enveloped, positively stranded RNA leading to not only respiratory disease, but also multiorgan envolvement. Cardiac complication is one of the manifestation of COVID-19 infection and patients may present with heart failure disease as a consequence of COVID-19 or exacerbation of underlying heart failure disease. History of heart failure disease, regardless of left ventricular ejection fraction, may be a risk factor of severity of COVID-19 course. During the pandemic, heart failure hospitalization reduced about 45% leading to increased in-hospital mortality rates. In addition, evidence of myocardial injury ranging 10-40% in critically ill COVID-19 patients and cardiovascular complications led to increased incidence of acute or chronic heart failure disease. Few cases of myocarditis and severe left ventricular systolic dysfunction associated COVID-19 have been reported. However, studies addressed both systolic and diastolic left ventricular dysfunction, left ventricular diastolic impairnment, pulmonary hypertension, right ventricular dysfunction as the consequence of cardiac involvement in COVID-19 patients.

Historical perspective

  • In late December 2019, the novel coronavirus, SARS-CoV-2, originated in Wuhan, China. [1]
  • The World Health Organization(WHO) declared the outbreak a Public Health Emergency of International Concern On January 30, 2020, [2] and a pandemic on March 12, 2020. [3]
  • On March 27, 2020, Inciardi et al. reported the first case of acute myopericarditis complicated by heart failure in an otherwise healthy 53-year-old woman one week after the onset of symptoms of COVID-19. [4]

Classification

  • Acute heart failure has two forms:
    • Newly-arisen (“de novo”) acute heart failure
    • Acutely decompensated chronic heart failure (ADCHF)

Pathophysiology







Common Precipitating factors in COVID-19 patients
Cardiac
Pressure overload
Volume overload
  • Renal dysfunction
Pulmonary
Increased systemic metabolic demand
Iatrogenic
  • Cardiovascular toxicity of medications
  • Aggressive fluid resuscitation
Others
  • Anemia

Causes

Acute heart failure in COVID-19 patients may be caused by: [12] [13]

Differentiating COVID-19 associated heart failure from other Diseases

  • For further information about the differential diagnosis, click here.

Epidemiology and Demographics

Age

Gender

Race

Risk Factors

To read more on the risk factors of congestive heart failure, click here.

Screening

  • There is insufficient evidence to recommend routine screening for heart failure in COVID-19 patients.
  • Routine measurement of natriuretic peptides and/or cardiac troponins has not been recommended in the absence of a high index of suspicion for heart failure on the clinical grounds.

Natural History, Complications, and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography or Ultrasound

CT scan

CMR

Other Imaging Findings

  • To view other imaging findings on COVID-19, click here.

Other Diagnostic Studies

  • To view other diagnostic studies for COVID-19, click here.

Treatment

Medical Therapy

Interventional therapy

Surgery

Primary Prevention

Secondary Prevention

References

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  18. Rey JR, Caro-Codón J, Rosillo SO, Iniesta ÁM, Castrejón-Castrejón S, Marco-Clement I, Martín-Polo L, Merino-Argos C, Rodríguez-Sotelo L, García-Veas JM, Martínez-Marín LA, Martínez-Cossiani M, Buño A, Gonzalez-Valle L, Herrero A, López-Sendón JL, Merino JL (December 2020). "Heart failure in COVID-19 patients: prevalence, incidence and prognostic implications". Eur J Heart Fail. 22 (12): 2205–2215. doi:10.1002/ejhf.1990. PMC 7461427 Check |pmc= value (help). PMID 32833283 Check |pmid= value (help).
  19. 19.0 19.1 Shah N, Ahmed I, Nazir T (February 2021). "Heart failure-related hospitalisation and management during the COVID-19 pandemic: a reflection. Letter regarding the article 'The impact of COVID-19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic'". Eur J Heart Fail. 23 (2): 343–344. doi:10.1002/ejhf.1931. PMC 7300617 Check |pmc= value (help). PMID 32519793 Check |pmid= value (help).
  20. Cannatà A, Bromage DI, Rind IA, Gregorio C, Bannister C, Albarjas M, Piper S, Shah AM, McDonagh TA (December 2020). "Temporal trends in decompensated heart failure and outcomes during COVID-19: a multisite report from heart failure referral centres in London". Eur J Heart Fail. 22 (12): 2219–2224. doi:10.1002/ejhf.1986. PMC 7461082 Check |pmc= value (help). PMID 32809274 Check |pmid= value (help).
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