COVID-19 electrocardiogram: Difference between revisions
Jump to navigation
Jump to search
| Line 6: | Line 6: | ||
There are no specific [[ECG]] findings associated with coronavirus [[infection]]. Non specific findings can include [[sinus tachycardia]], ST-elevation and diffuse [[T wave]] inversion. | 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== | ==Electrocardiogram== | ||
*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> | |||
*Most of the findings are ST-T abnormalities,and left ventricular hypertrophy, atrial fibrillation,tachy-brady syndrome, and changes consistent with acute pericarditis.<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> | *Most of the findings are ST-T abnormalities,and left ventricular hypertrophy, atrial fibrillation,tachy-brady syndrome, and changes consistent with acute pericarditis.<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> | ||
*COVID-19 has been associated with complete | *COVID-19 has been associated with complete heart block, acute coronary syndromes, myocarditis, decompensated heart failure, and pulmonary embolisms.<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> | ||
*Severe stages of COVID-19 have been attributed to possible hypoxia and inflammatory damage incurred by the virus.<ref name="HeWu2020">{{cite journal|last1=He|first1=Jia|last2=Wu|first2=Bo|last3=Chen|first3=Yaqin|last4=Tang|first4=Jianjun|last5=Liu|first5=Qiming|last6=Zhou|first6=Shenghua|last7=Chen|first7=Chen|last8=Qin|first8=Qingwu|last9=Huang|first9=Kang|last10=Lv|first10=Jianlei|last11=Chen|first11=Yan|last12=Peng|first12=Daoquan|title=Characteristic Electrocardiographic Manifestations in Patients With COVID-19|journal=Canadian Journal of Cardiology|volume=36|issue=6|year=2020|pages=966.e1–966.e4|issn=0828282X|doi=10.1016/j.cjca.2020.03.028}}</ref> | *Severe stages of COVID-19 have been attributed to possible hypoxia and inflammatory damage incurred by the virus.<ref name="HeWu2020">{{cite journal|last1=He|first1=Jia|last2=Wu|first2=Bo|last3=Chen|first3=Yaqin|last4=Tang|first4=Jianjun|last5=Liu|first5=Qiming|last6=Zhou|first6=Shenghua|last7=Chen|first7=Chen|last8=Qin|first8=Qingwu|last9=Huang|first9=Kang|last10=Lv|first10=Jianlei|last11=Chen|first11=Yan|last12=Peng|first12=Daoquan|title=Characteristic Electrocardiographic Manifestations in Patients With COVID-19|journal=Canadian Journal of Cardiology|volume=36|issue=6|year=2020|pages=966.e1–966.e4|issn=0828282X|doi=10.1016/j.cjca.2020.03.028}}</ref> | ||
*COVID-19 and acute myopericarditis: | *COVID-19 and acute myopericarditis: | ||
**low voltage in the limb leads, | **low voltage in the limb leads, ST-segment elevation and an ST-segment depression with T-wave inversion.<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><ref name="HeWu2020" /><ref name="Amaratunga Corwin2020" /><ref name="McculloughGoyal2020">{{cite journal|last1=Mccullough|first1=S. Andrew|last2=Goyal|first2=Parag|last3=Krishnan|first3=Udhay|last4=Choi|first4=Justin J.|last5=Safford|first5=Monika M.|last6=Okin|first6=Peter M.|title=Electrocardiographic Findings in Coronavirus Disease-19: Insights on Mortality and Underlying Myocardial Processes|journal=Journal of Cardiac Failure|year=2020|issn=10719164|doi=10.1016/j.cardfail.2020.06.005}}</ref> | ||
** | **PR elevation; COVID-19 induced pericarditis might reflect the expression of ACE2 receptors in epicardial adipocites.<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> | ||
** | **Sinus rhythm with a first-degree atrioventricular block (AVB) with SITIIIQIII;Sinus tachycardia with incomplete right bundle branch block.<ref name="HeWu2020">{{cite journal|last1=He|first1=Jia|last2=Wu|first2=Bo|last3=Chen|first3=Yaqin|last4=Tang|first4=Jianjun|last5=Liu|first5=Qiming|last6=Zhou|first6=Shenghua|last7=Chen|first7=Chen|last8=Qin|first8=Qingwu|last9=Huang|first9=Kang|last10=Lv|first10=Jianlei|last11=Chen|first11=Yan|last12=Peng|first12=Daoquan|title=Characteristic Electrocardiographic Manifestations in Patients With COVID-19|journal=Canadian Journal of Cardiology|volume=36|issue=6|year=2020|pages=966.e1–966.e4|issn=0828282X|doi=10.1016/j.cjca.2020.03.028}}</ref><ref name="McculloughGoyal2020" /> | ||
*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. 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> | |||
**The inflammatory cytokines released during the stage of overwhelming immune response, acting on the cardiac pacemaker cells could possibly contribute to bradycardia. It may be that the high levels of pro-inflammatory cytokines, including IL-6 directly act on the sinoatrial (SA) node.<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> | |||
* | * | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 21:17, 27 June 2020
|
COVID-19 Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
COVID-19 electrocardiogram On the Web |
|
American Roentgen Ray Society Images of COVID-19 electrocardiogram |
|
Risk calculators and risk factors for COVID-19 electrocardiogram |
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
- There are no specific ECG findings associated with coronavirus infection.
- Non specific findings can include sinus tachycardia, ST-elevation and diffuse T wave inversion.[1]
- Most of the findings are ST-T abnormalities,and left ventricular hypertrophy, atrial fibrillation,tachy-brady syndrome, and changes consistent with acute pericarditis.[2]
- COVID-19 has been associated with complete heart block, acute coronary syndromes, myocarditis, decompensated heart failure, and pulmonary embolisms.[2]
- Severe stages of COVID-19 have been attributed to possible hypoxia and inflammatory damage incurred by the virus.[3]
- COVID-19 and acute myopericarditis:
- low voltage in the limb leads, ST-segment elevation and an ST-segment depression with T-wave inversion.[4][3][2][5]
- PR elevation; COVID-19 induced pericarditis might reflect the expression of ACE2 receptors in epicardial adipocites.[2]
- Sinus rhythm with a first-degree atrioventricular block (AVB) with SITIIIQIII;Sinus tachycardia with incomplete right bundle branch block.[3][5]
- 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. Severe deterioration in some patients with COVID-19 being closely related to the cytokine storm.[6]
- The inflammatory cytokines released during the stage of overwhelming immune response, acting on the cardiac pacemaker cells could possibly contribute to bradycardia. It may be that the high levels of pro-inflammatory cytokines, including IL-6 directly act on the sinoatrial (SA) node.[2]
References
- ↑ 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.
- ↑ 2.0 2.1 2.2 2.3 2.4 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.
- ↑ 3.0 3.1 3.2 He, Jia; Wu, Bo; Chen, Yaqin; Tang, Jianjun; Liu, Qiming; Zhou, Shenghua; Chen, Chen; Qin, Qingwu; Huang, Kang; Lv, Jianlei; Chen, Yan; Peng, Daoquan (2020). "Characteristic Electrocardiographic Manifestations in Patients With COVID-19". Canadian Journal of Cardiology. 36 (6): 966.e1–966.e4. doi:10.1016/j.cjca.2020.03.028. ISSN 0828-282X.
- ↑ 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.
- ↑ 5.0 5.1 Mccullough, S. Andrew; Goyal, Parag; Krishnan, Udhay; Choi, Justin J.; Safford, Monika M.; Okin, Peter M. (2020). "Electrocardiographic Findings in Coronavirus Disease-19: Insights on Mortality and Underlying Myocardial Processes". Journal of Cardiac Failure. doi:10.1016/j.cardfail.2020.06.005. ISSN 1071-9164.
- ↑ 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.