Complete AV Block in Vaccinated COVID-19 Patient

Area of Science:

• Cardiology
• Infectious Diseases
• Virology

Background:

• Coronavirus 2019 (COVID-19) emerged in late 2019, initially presenting with respiratory symptoms.
• Cardiac manifestations of COVID-19 are diverse, including arrhythmias and heart failure.
• Vaccination against COVID-19 is a key preventive strategy.

Observation:

• An 84-year-old male, vaccinated against COVID-19, presented with prodromal symptoms and was diagnosed with COVID-19 and complete atrioventricular (AV) block.
• The patient had a history of coronary artery disease, hypertension, and hyperlipidemia.
• Despite transfer to a tertiary center, the patient refused invasive cardiac interventions and was discharged with complete AV block.

Findings:

• This case presents a novel association of complete AV block as an initial symptom of COVID-19 in a vaccinated individual.
• Potential etiologies for the complete AV block include viral myocarditis, COVID-19-induced Takotsubo cardiomyopathy, or direct conduction pathway infection.
• The case underscores the challenges in managing complex cardiac presentations of COVID-19.

Implications:

• Management requires a multidisciplinary approach for patients with COVID-19 and cardiac complications.
• Early recognition and intervention are crucial for improving outcomes in COVID-19 cardiac cases.
• Continued emphasis on COVID-19 vaccination is vital for preventing severe disease and its cardiac sequelae.