COVID-19 electrocardiogram: Difference between revisions
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*COVID-19 and acute myopericarditis: | *COVID-19 and acute myopericarditis: | ||
**low voltage in the limb leads, minimal diffuse ST-segment elevation (more prominent in the inferior and lateral leads), and an ST-segment depression with T-wave inversion in lead V1 and aVR.<ref name="InciardiLupi2020">{{cite journal|last1=Inciardi|first1=Riccardo M.|last2=Lupi|first2=Laura|last3=Zaccone|first3=Gregorio|last4=Italia|first4=Leonardo|last5=Raffo|first5=Michela|last6=Tomasoni|first6=Daniela|last7=Cani|first7=Dario S.|last8=Cerini|first8=Manuel|last9=Farina|first9=Davide|last10=Gavazzi|first10=Emanuele|last11=Maroldi|first11=Roberto|last12=Adamo|first12=Marianna|last13=Ammirati|first13=Enrico|last14=Sinagra|first14=Gianfranco|last15=Lombardi|first15=Carlo M.|last16=Metra|first16=Marco|title=Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)|journal=JAMA Cardiology|year=2020|issn=2380-6583|doi=10.1001/jamacardio.2020.1096}}</ref> | **low voltage in the limb leads, minimal diffuse ST-segment elevation (more prominent in the inferior and lateral leads), and an ST-segment depression with T-wave inversion in lead V1 and aVR.<ref name="InciardiLupi2020">{{cite journal|last1=Inciardi|first1=Riccardo M.|last2=Lupi|first2=Laura|last3=Zaccone|first3=Gregorio|last4=Italia|first4=Leonardo|last5=Raffo|first5=Michela|last6=Tomasoni|first6=Daniela|last7=Cani|first7=Dario S.|last8=Cerini|first8=Manuel|last9=Farina|first9=Davide|last10=Gavazzi|first10=Emanuele|last11=Maroldi|first11=Roberto|last12=Adamo|first12=Marianna|last13=Ammirati|first13=Enrico|last14=Sinagra|first14=Gianfranco|last15=Lombardi|first15=Carlo M.|last16=Metra|first16=Marco|title=Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)|journal=JAMA Cardiology|year=2020|issn=2380-6583|doi=10.1001/jamacardio.2020.1096}}</ref> | ||
**ECG signs of acute pericarditis concave ST elevation and PR depression throughout most of the limb (I, II, III, aVL, aVF) and precordial (V2-V6) leads, reciprocal ST depression and PR elevation in aVR, and a ST segment/T wave ratio> 0.25. COVID-19 induced pericarditis might reflect the expression of ACE2 receptors in epicardial adipocites, mediating the cell entry of SARS-CoV-2 and possibly triggering local inflammation.<ref name="Amaratunga Corwin2020">{{cite journal|last1=Amaratunga |first1=Eluwana A|last2=Corwin|first2=Douglas S|last3=Moran|first3=Lynn|last4=Snyder|first4=Richard|title=Bradycardia in Patients With COVID-19: A Calm Before the Storm?|journal=Cureus|year=2020|issn=2168-8184|doi=10.7759/cureus.8599}}</ref> | |||
*Relative bradycardia in Patients With COVID-19: The pathogenesis is poorly understood,cardiac pacemaker cells may be a target for inflammatory cytokines resulting in a change in heart rate dynamics or their responsiveness to neurotransmitters during systemic inflammation. This is particularly interesting because recent studies show evidence of severe deterioration in some patients with COVID-19 being closely related to the cytokine storm.<ref name="YeWang2020">{{cite journal|last1=Ye|first1=Qing|last2=Wang|first2=Bili|last3=Mao|first3=Jianhua|title=The pathogenesis and treatment of the `Cytokine Storm' in COVID-19|journal=Journal of Infection|volume=80|issue=6|year=2020|pages=607–613|issn=01634453|doi=10.1016/j.jinf.2020.03.037}}</ref>. | |||
* There are no specific [[ECG]] findings associated with coronavirus [[infection]]. | * There are no specific [[ECG]] findings associated with coronavirus [[infection]]. | ||
* Non specific findings can include [[sinus tachycardia]], ST-elevation and diffuse [[T wave]] inversion.<ref name="pmid26922692">{{cite journal |vauthors=Alhogbani T |title=Acute myocarditis associated with novel Middle east respiratory syndrome coronavirus |journal=Ann Saudi Med |volume=36 |issue=1 |pages=78–80 |date=2016 |pmid=26922692 |pmc=6074274 |doi=10.5144/0256-4947.2016.78 |url=}}</ref> | * Non specific findings can include [[sinus tachycardia]], ST-elevation and diffuse [[T wave]] inversion.<ref name="pmid26922692">{{cite journal |vauthors=Alhogbani T |title=Acute myocarditis associated with novel Middle east respiratory syndrome coronavirus |journal=Ann Saudi Med |volume=36 |issue=1 |pages=78–80 |date=2016 |pmid=26922692 |pmc=6074274 |doi=10.5144/0256-4947.2016.78 |url=}}</ref> | ||
Revision as of 21:40, 26 June 2020
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COVID-19 electrocardiogram On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]; Syed Hassan A. Kazmi BSc, MD [3]
Overview
There are no specific ECG findings associated with coronavirus infection. Non specific findings can include sinus tachycardia, ST-elevation and diffuse T wave inversion.
Electrocardiogram
- Most of the findings are ST-T abnormalities,and left ventricular hypertrophy, atrial fibrillation,tachy-brady syndrome, and changes consistent with acute pericarditis.[1]
- COVID-19 has been associated with complete hart block, acute coronary syndromes, myocarditis, decompensated heart failure, and pulmonary embolisms.[1]
- COVID-19 and acute myopericarditis:
- low voltage in the limb leads, minimal diffuse ST-segment elevation (more prominent in the inferior and lateral leads), and an ST-segment depression with T-wave inversion in lead V1 and aVR.[2]
- ECG signs of acute pericarditis concave ST elevation and PR depression throughout most of the limb (I, II, III, aVL, aVF) and precordial (V2-V6) leads, reciprocal ST depression and PR elevation in aVR, and a ST segment/T wave ratio> 0.25. COVID-19 induced pericarditis might reflect the expression of ACE2 receptors in epicardial adipocites, mediating the cell entry of SARS-CoV-2 and possibly triggering local inflammation.[1]
- Relative bradycardia in Patients With COVID-19: The pathogenesis is poorly understood,cardiac pacemaker cells may be a target for inflammatory cytokines resulting in a change in heart rate dynamics or their responsiveness to neurotransmitters during systemic inflammation. This is particularly interesting because recent studies show evidence of severe deterioration in some patients with COVID-19 being closely related to the cytokine storm.[3].
- There are no specific ECG findings associated with coronavirus infection.
- Non specific findings can include sinus tachycardia, ST-elevation and diffuse T wave inversion.[4]
References
- ↑ 1.0 1.1 1.2 Amaratunga, Eluwana A; Corwin, Douglas S; Moran, Lynn; Snyder, Richard (2020). "Bradycardia in Patients With COVID-19: A Calm Before the Storm?". Cureus. doi:10.7759/cureus.8599. ISSN 2168-8184.
- ↑ Inciardi, Riccardo M.; Lupi, Laura; Zaccone, Gregorio; Italia, Leonardo; Raffo, Michela; Tomasoni, Daniela; Cani, Dario S.; Cerini, Manuel; Farina, Davide; Gavazzi, Emanuele; Maroldi, Roberto; Adamo, Marianna; Ammirati, Enrico; Sinagra, Gianfranco; Lombardi, Carlo M.; Metra, Marco (2020). "Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)". JAMA Cardiology. doi:10.1001/jamacardio.2020.1096. ISSN 2380-6583.
- ↑ Ye, Qing; Wang, Bili; Mao, Jianhua (2020). "The pathogenesis and treatment of the `Cytokine Storm' in COVID-19". Journal of Infection. 80 (6): 607–613. doi:10.1016/j.jinf.2020.03.037. ISSN 0163-4453.
- ↑ Alhogbani T (2016). "Acute myocarditis associated with novel Middle east respiratory syndrome coronavirus". Ann Saudi Med. 36 (1): 78–80. doi:10.5144/0256-4947.2016.78. PMC 6074274. PMID 26922692.