COVID-19 induced ventricular tachycardia storm unmasking a clinically silent cardiomyopathy: a case report
| Autor: | Rupesh Agarwal, Saibal Mukhopadhyay, Ghazi Muheeb, Abhimanyu Uppal, Jamal Yusuf |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Cardiomyopathy Cytokine surge 030204 cardiovascular system & hematology Ventricular tachycardia Asymptomatic Right ventricular cardiomyopathy 03 medical and health sciences 0302 clinical medicine Internal medicine Case report ARVC VT storm medicine AcademicSubjects/MED00200 Sinus rhythm AICD business.industry COVID-19 Emergency department medicine.disease Arrhythmogenic right ventricular dysplasia Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business Cytokine storm 030217 neurology & neurosurgery |
| Zdroj: | European Heart Journal: Case Reports |
| ISSN: | 2514-2119 |
| Popis: | Background Coronavirus disease (COVID-19) is a systemic illness characterized by raging impact of cytokine storm on multiple organs. This may trigger malignant ventricular arrhythmias and unmask a clinically silent cardiomyopathy. Case summary A 57-year-old gentleman, known case of hyperthyroidism and diabetes, was referred to our emergency department with history of two ventricular tachycardia (VT) episodes requiring direct current cardioversion in last 3 h followed by another episode in our emergency department that was cardioverted. There was no past history of cardiac illness. His 12-lead electrocardiogram (during sinus rhythm) along with screening echocardiography suggested Arrhythmogenic right ventricular cardiomyopathy (ARVC). He was coincidentally found to be COVID-19 positive by reverse transcription-polymerase chain reaction (RT-PCR) as part of our routine screening. However, he had no fever or respiratory complaints. We noted raised systemic inflammatory markers and cardiac troponin T which progressively increased over the next 4 weeks paralleled by an increase in ventricular premature contraction burden and thereafter started decreasing and returned to baseline by 6th week when the patient became COVID-19 negative by RT-PCR. Subsequently, a single-chamber automated implantable cardioverter-defibrillator implantation was done following which there was a transient increase in these biomarkers that subsided spontaneously. The patient is asymptomatic during 6 weeks of follow-up. Discussion COVID-19-associated cytokine surge triggering VT storm and unmasking a clinically silent ARVC has not yet been reported. The case highlights a life-threatening presentation of COVID-19 and indicates a probable link between inflammation and arrhythmogenicity. |
| Databáze: | OpenAIRE |
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