ISSN 2466-2992 (Online) (2021) br.2, p. 27-34
VENTRICULAR TACHYCARDIA IN A COVID-19 POSITIVE PATIENT - A CASE REPORT
Snežana Mitrović, Aleksandra Mihajlov
Emergency Medicine Service Niš, Serbia
INTRODUCTION: COVID-19 disease has led to over four million deaths worldwide and is associated with cardiac complications, including arrhythmias. A large number of patients who were hospitalized for respiratory infections had elevated troponin levels and it was suspected that SARS-Cov-2 could cause myocardial damage and myocarditis that could cause arrhythmias, heart failure, and cardiac arrest. A 58% increase in outpatient cardiac arrest in the Italian region of Lombardy during the first 40 days of the COVID-19 pandemic and France by 52% during the two-month period between February and April 2020 compared to 2019 has raised concerns about arrhythmias associated with SARS-Cov-2 infection. Stress due to a pandemic, fear of infection and delay in seeking medical help are possible risk factors, also. Among hospitalized patients who experienced cardiac arrest, the initial rhythm that does not defibrillate, such as pulseless electric activity, bradycardia and asystole, were more common. This suggests that severe hypoxemia and critical illness are the primary triggers of cardiac arrest in these patients, not myocardial damage or electrical disturbances leading to primary cardiac arrest.
OBJECTIVE: To show COVID-19 patients with ventricular tachycardia and positive cardiopulmonary resuscitation (CPR).
METHODS AND MATERIAL: The medical report of the Institute of Emergency Medicine Nis, specialist reports of the internist of the Health Center and the discharge list of the Covid Hospital and the Clinic for Cardiovascular Diseases of the Clinical Center Nis were analyzed.
CASE REPORT: The paper presents a patient with COVID-19 infection who had ventricular tachycardia, cardiac arrest and successful CPR.
DISCUSSION: The frequency and pathophysiology of these manifestations remain unknown. Coexisting hypoxia, electrolyte disturbances, administration of arrhythmogenic drugs, and incomplete histopathological evaluation make it difficult to determine the direct and indirect contribution of COVID-19 to cardiac arrhythmias. Most patients with arrhythmias had comorbid conditions including congestive heart failure and coronary artery disease and were likely to be predisposed to developing cardiac arrhythmias. Timely recognition and treatment of acute cardiac events in the emergency room during the COVID-19 pandemic is a unique challenge.
CONCLUSION: The causes of arrhythmias in patients with COVID-19 have not been fully examined and are likely to be multifactorial. Precise medical examinations and randomized studies are needed to explane the leading cause.
Key words: ventricular tachycardia, COVID-19, cardiac arrest, successful resuscitation
Emergency Medical Service Niš
Vojislava Ilića bb