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Ischemic Heart Disease: Overview01:17

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Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Updated: Nov 30, 2025

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Microtrombos de fibrina no oclusiva asociados con el COVID-19 en el corazón

Melanie C Bois1, Nicholas A Boire1, Andrew J Layman1

  • 1Department of Laboratory Medicine and Pathology (M.C.B., N.A.B., A.J.L., M.-C.A., M.P.A., A.C.R., C.E.H., R.A.Q., R.M., B.R.K., P.T.L., J.J.M.), Mayo Clinic, Rochester, MN.

Circulation
|November 16, 2020
PubMed
Resumen

Este estudio no encontró infección cardíaca directa por SARS-CoV-2, pero reveló microtrombias de fibrina cardíaca comunes en pacientes con COVID-19. La miocarditis estuvo presente en algunos casos, y la amiloidosis cardíaca puede empeorar los resultados graves de COVID-19.

Palabras clave:
El COVID-19En el caso del SARS-CoV-2la autopsiael corazónpatología

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Área de la Ciencia:

  • Cardiología
  • Virología
  • Patología

Sus antecedentes:

  • El coronavirus 2 del síndrome respiratorio agudo severo (SARS-CoV-2) causa COVID-19, una amenaza global para la salud con frecuentes complicaciones cardíacas.
  • Los mecanismos precisos detrás de los problemas cardíacos relacionados con el COVID-19 siguen siendo en gran medida desconocidos.
  • Las evaluaciones cardíacas postmortem son cruciales para comprender la patología de la infección por SARS-CoV-2.

Objetivo del estudio:

  • Para detallar el espectro patológico miocárdico en pacientes con COVID-19.
  • Para comparar los hallazgos cardíacos en COVID-19 con otras enfermedades virales.
  • Investigar la expresión de la enzima convertidora de angiotensina 2 (ACE2) en el corazón y describir los hallazgos cardíacos en casos de infección eliminados.

Principales métodos:

  • Evaluación cardíaca postmortem de los casos de COVID-19 (n=15), la gripe (n=6) y el grupo de control (n=6).
  • Análisis histopatológico, inmunohistoquímica para ACE2, examen ultrastructural y RT-PCR para la detección viral.
  • Comparación de los hallazgos entre diferentes grupos de enfermedades y estados clínicos (infección activa vs. eliminada).

Principales resultados:

  • Los microtrombos de fibrina no específicos fueron comunes en los casos activos de COVID-19 (P=0,006).
  • Se observó miocarditis focal en casos activos (33,3%) y eliminados de COVID-19, generalmente de alcance limitado.
  • Se observó una menor expresión endotelial de ACE2 en los casos de COVID-19 (P=0,004), pero la expresión de ACE2 en el miocardio no fue diferente.
  • La amiloidosis cardíaca se identificó en el 26,7% de los pacientes con COVID-19.

Conclusiones:

  • No se identificó definitivamente ninguna infección miocárdica directa por SARS-CoV-2.
  • Los microtromos de fibrina cardíaca son frecuentes en el COVID-19, pero no están universalmente relacionados con la lesión isquémica.
  • La miocarditis ocurre en un subconjunto de pacientes con COVID-19, con una presentación variable en infecciones eliminadas.
  • La amiloidosis cardíaca puede representar un factor de riesgo adicional para la enfermedad grave por COVID-19.