Postoperative myocardial injury in a patient with left ureteric stone and asymptomatic COVID-19 disease

Nadeem Kassam1, Omar Aziz2, Ally Zain Ismail3

  • 1Department of Internal medicine, Aga Khan University, Medical college, East Africa.

Insights

Asymptomatic COVID-19 can cause myocardial injury, even in patients undergoing surgery. This case underscores the need for thorough preoperative evaluation to identify and manage potential cardiac complications during the pandemic.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is a global health emergency.
  • COVID-19 presents with a spectrum of illness, from asymptomatic infection to severe pneumonia and ARDS.
  • SARS-CoV-2 can lead to myocardial injury, indicated by ECG changes or elevated troponin levels, associated with poor outcomes.

Observation:

  • A case report of a hypertensive male with undiagnosed, asymptomatic COVID-19 undergoing emergency urologic surgery for ureteric calculi.
  • The patient developed postoperative myocardial injury, leading to a fatal outcome.

Findings:

  • Undiagnosed, asymptomatic COVID-19 poses a significant risk for postoperative myocardial injury.
  • Myocardial injury in COVID-19 patients, even those without symptoms, is linked to severe illness and mortality.

Implications:

  • Highlights the critical importance of comprehensive preoperative assessment in the context of the COVID-19 pandemic.
  • Emphasizes the need to anticipate and manage potential cardiac complications in surgical patients with undiagnosed SARS-CoV-2 infection.
  • Underscores the potential for severe outcomes in patients with asymptomatic COVID-19 and myocardial involvement.

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