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Coronavirus and cardiovascular manifestations- getting to the heart of the matter
Monika Bhandari1, Akshyaya Pradhan2, Pravesh Vishwakarma1
1Department of Cardiology, King George's Medical University, Lucknow 226003, Uttar Pradesh, India.
Insights
Coronavirus disease 2019 (COVID-19) significantly impacts the heart, causing varied cardiac issues and potential thromboembolism. This review covers COVID-19
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic has caused widespread illness and mortality globally.
- Cardiac manifestations are common in COVID-19 patients, ranging from mild troponin elevation to severe myocarditis.
- Understanding cardiovascular complications and management is crucial.
Purpose of the Study:
- To review the cardiac manifestations of COVID-19.
- To discuss the pathogenesis of myocardial damage in COVID-19.
- To explore management strategies for cardiac patients with COVID-19 and address vaccine-related thromboembolism.
Main Methods:
- Literature review of studies on COVID-19 and cardiovascular disease.
- Analysis of reported cases of cardiac involvement and thromboembolism.
- Synthesis of current management guidelines and emerging research.
Main Results:
- COVID-19 can lead to diverse cardiac issues, including myocarditis and thromboembolic events.
- Myocardial damage may result from direct viral effects, inflammation, or cytokine storms.
- Anticoagulation strategies and drug interactions require careful consideration.
- Vaccine-associated thromboembolism is a noted concern.
Conclusions:
- COVID-19 poses significant cardiovascular risks requiring comprehensive management.
- Further research is needed on long-term cardiac outcomes and optimal therapeutic interventions.
- Careful monitoring and management are essential for cardiac patients during the pandemic and post-vaccination.
Abstract:
Coronavirus disease has unarguably been the largest pandemic of recent times. Over 150 million cases have occurred worldwide, and more than 3 million have succumbed to the disease. Cardiac manifestations can have varied presentations from an asymptomatic troponin rise to fulminant myocarditis. The pathogenesis of myocardial damage could be direct or indirect, including inflammation, coronary spasm, plaque rupture, and cytokine storm. Thromboembolism is also an important feature of cardiovascular affliction with both arterial and venous systems being affected. Hence, anticoagulation has also been a matter of debate. Fulminant myocarditis is the most severe form and can lead to circulatory shock with a high mortality. Management of cardiac patients with coronavirus disease 2019 (COVID-19) infection is not considerably different from non-COVID-19 cardiovascular disease, but interaction between cardiovascular drugs and anti-COVID-19 therapy requires careful attention. More recently, vaccines have emerged as a ray of hope for the disease. But simultaneously, there have been reports of thromboembolism following vaccination. In this review, we discuss the various aspects of coronavirus disease affecting of heart and its management.
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