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Complete Heart Block Secondary to COVID-19
1Internal Medicine, Rochester Regional Health, Rochester, USA.
Cureus
|June 14, 2021
Summary
COVID-19 patients often present with bradycardia, not tachycardia, even when critically ill. This condition can progress to complete heart block and cardiac arrest, requiring prompt medical intervention.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- COVID-19 is frequently associated with cardiac complications.
- Bradycardia is an observed phenomenon in some critically ill COVID-19 patients, contrary to typical tachycardic responses in shock.
Observation:
- Critically ill COVID-19 patients, including those in septic shock, may exhibit significant bradycardia (heart rates in the 50s or lower).
- Some patients develop transient complete heart block, leading to cardiac arrest.
- A case study highlights a 72-year-old female with COVID-19 bronchopneumonia who experienced bradycardia, complete heart block, and subsequent cardiac arrest.
Findings:
- The patient required a temporary pacemaker due to complete heart block and cardiac arrest.
- Following recovery, the patient's heart rate gradually normalized, transitioning from junctional tachycardia to sinus rhythm.
- The patient was discharged with a monitor, showing no recurrence of bradycardia.
Implications:
- Bradycardia in COVID-19 is not always benign and can indicate serious cardiac events like advanced heart block.
- Prompt recognition and management of bradycardia and heart block in COVID-19 patients are crucial.
- This highlights the need for vigilant cardiac monitoring in severe COVID-19 cases.
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