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Paroxysmal Atrioventricular Block in a Relatively Young Patient with COVID-19
Masami Abe1, Suguru Chiba1, Sayuri Kataoka1
1Department of cardiology, Urasoe General Hospital, Japan.
Insights
Coronavirus disease 2019 (COVID-19) can affect the heart. This case study details a COVID-19 patient with unexplained heart block, showing mild fibrosis without inflammation.
Area of Science:
- Cardiology
- Infectious Diseases
- Pathology
Background:
- Cardiac involvement is a known complication of coronavirus disease 2019 (COVID-19).
- Atrioventricular block is a potential manifestation of cardiac compromise.
Observation:
- A 41-year-old male presented with recurrent paroxysmal atrioventricular block.
- The patient had a confirmed diagnosis of COVID-19.
- Initial cardiac assessments including biomarkers, echocardiography, and MRI were unremarkable.
Findings:
- Endomyocardial biopsy revealed mild myocardial fibrosis.
- No significant inflammatory infiltrates were observed in the myocardial tissue.
- The findings suggest an unusual myocardial involvement by the novel coronavirus.
Implications:
- This case highlights the potential for COVID-19 to cause cardiac dysfunction through mechanisms beyond typical inflammation or injury.
- Further research is needed to understand the direct or indirect effects of SARS-CoV-2 on cardiac conduction and structure.
- This presentation underscores the importance of considering cardiac complications in COVID-19 patients, even in the absence of overt cardiac injury markers.
Abstract:
Cardiac involvement has been reported in patients with coronavirus disease 2019 (COVID-19). We herein report a 41-year-old man who presented with recurrent paroxysmal atrioventricular block without showing significant cardiac injuries or comorbidities. The patient was diagnosed with COVID-19 and admitted to our hospital, where he was noted to have paroxysmal atrioventricular block. Cardiac biomarkers, echocardiography, and cardiac magnetic resonance imaging findings were fairly normal. An endomyocardial biopsy performed before the implantation of a permanent pacemaker revealed mild myocardial fibrosis without inflammatory infiltrates. The unusual myocardial involvement of the novel coronavirus was suspected.
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