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The history of patients presented cardiogenic shock related to COVID-19, according to a few anecdotal reports were different. Some did not have any cardiovascular risk factors. | The history of patients presented cardiogenic shock related to COVID-19, according to a few anecdotal reports were different. Some did not have any cardiovascular risk factors. | ||
* | :*A 69-year-old patient from Italy has been reported by Tavazzi et al., as a cardiogenic shock-associated COVID-19 case. The patient had flu-like symptoms when he was hospitalized and quickly deteriorated into respiratory distress and cardiogenic shock. <ref name="TavazziPellegrini2020">{{cite journal|last1=Tavazzi|first1=Guido|last2=Pellegrini|first2=Carlo|last3=Maurelli|first3=Marco|last4=Belliato|first4=Mirko|last5=Sciutti|first5=Fabio|last6=Bottazzi|first6=Andrea|last7=Sepe|first7=Paola Alessandra|last8=Resasco|first8=Tullia|last9=Camporotondo|first9=Rita|last10=Bruno|first10=Raffaele|last11=Baldanti|first11=Fausto|last12=Paolucci|first12=Stefania|last13=Pelenghi|first13=Stefano|last14=Iotti|first14=Giorgio Antonio|last15=Mojoli|first15=Francesco|last16=Arbustini|first16=Eloisa|title=Myocardial localization of coronavirus in COVID‐19 cardiogenic shock|journal=European Journal of Heart Failure|volume=22|issue=5|year=2020|pages=911–915|issn=1388-9842|doi=10.1002/ejhf.1828}}</ref> | ||
Four patients with cardiogenic shock complication related to COVID-19 were reported by Sanchez-Recalde, et al. They were hospitalized between 1 March and 15 April 2020 including:<ref name="Sánchez-RecaldeSolano-López2020">{{cite journal|last1=Sánchez-Recalde|first1=Ángel|last2=Solano-López|first2=Jorge|last3=Miguelena-Hycka|first3=Javier|last4=Martín-Pinacho|first4=Jesús Javier|last5=Sanmartín|first5=Marcelo|last6=Zamorano|first6=José L.|title=COVID-19 and cardiogenic shock. Different cardiovascular presentations with high mortality|journal=Revista Española de Cardiología (English Edition)|year=2020|issn=18855857|doi=10.1016/j.rec.2020.04.012}}</ref> | |||
* | :*A 42-year-old woman, who had dyslipidemia as a cardiovascular risk factor | ||
* | :*A 50-year-old man, without any cardiovascular risk factors, admitted by severe bilateral pneumonia related to COVID-19. After a few hours, he developed cardiogenic shock. | ||
* | :*A 75-year-old man did not have any cardiovascular risk factors and was admitted due to dyspnea, chest pain, and bilateral SARS-CoV-2 pneumonia. | ||
:*A 37-year-old woman, obese with a history of deep venous thrombosis, had symptoms of dyspnea and chest pain | |||
=== Physical Examination === | === Physical Examination === | ||
Revision as of 11:43, 30 June 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Historical Perspective
- In Italy, for the first time in a 69-year-old patient, who was presented with cardiogenic shock due to COVID-19 infection, myocardial involvement by viral particles was pathologically proved through biopsy. [1]
Classification
There is no specific classification for COVID-19 associated cardiogenic shock. For more information regarding general classification, see the cardiogenic shock classification.
Pathophysiology
Two mechanisms are more probable to contribute to cardiogenic shock related to Covid-19:
- Direct invasion of the virus into the cardiomyocytes
- Cytokine storm activated by T helper cells (Th1 and Th2) and trigger a systemic hyperinflammatory response.[2] [3]
Differentiating COVID-19 associated cardiogenic shock from other Diseases
- Cardiogenic shock related to COVID-19 must be differentiated from other diseases when hemodynamics not changing, such as:
Epidemiology and Demographics
- The prevalence of cardiogenic shock-associated COVID-19 has not yet been reported.There are several anecdotal reports of cardiogenic shock related to COVID-19:
- A 69-year-old patient from Italy has been reported by Tavazzi et al., as a cardiogenic shock-associated COVID-19 case. The patient had flu-like symptoms when he was hospitalized and quickly deteriorated into respiratory distress and cardiogenic shock. [1]
- Four patients with cardiogenic shock complication related to COVID-19 were reported by Sanchez-Recalde, et al. They were hospitalized between 1 March and 15 April 2020 including:
- A 42-year-old woman, who had dyslipidemia as a cardiovascular risk factor
- A 50-year-old man, without any cardiovascular risk factors, admitted by severe bilateral pneumonia related to COVID-19. After a few hours, he developed cardiogenic shock.
- A 75-year-old man did not have any cardiovascular risk factors and was admitted due to dyspnea, chest pain, and bilateral SARS-CoV-2 pneumonia.
- A 37-year-old woman, obese with a history of deep venous thrombosis, had symptoms of dyspnea and chest pain [6]
Causes
The causes of cardiogenic shock related to COVID-19 might include:
- Newly emerging COVID-19 associated myocarditis, cardiac arrhythmias, cardiomyopathy, or an acute coronary syndrome deteriorated into cardiogenic shock
- Worsening of previous left ventricular failure due to COVID-19 [7]
Complications and Prognosis
According to an observational study in China, COVID-19 associated cardiogenic shock has a poor prognosis. In spite of using Extracorporeal membrane oxygenation (ECMO), 83% of patients died. [8] [9]
Diagnosis
Diagnostic Criteria
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
- [criterion 1]
- [criterion 2]
- [criterion 3]
- [criterion 4]
Symptoms
The history of patients presented cardiogenic shock related to COVID-19, according to a few anecdotal reports were different. Some did not have any cardiovascular risk factors.
- A 69-year-old patient from Italy has been reported by Tavazzi et al., as a cardiogenic shock-associated COVID-19 case. The patient had flu-like symptoms when he was hospitalized and quickly deteriorated into respiratory distress and cardiogenic shock. [1]
Four patients with cardiogenic shock complication related to COVID-19 were reported by Sanchez-Recalde, et al. They were hospitalized between 1 March and 15 April 2020 including:[6]
- A 42-year-old woman, who had dyslipidemia as a cardiovascular risk factor
- A 50-year-old man, without any cardiovascular risk factors, admitted by severe bilateral pneumonia related to COVID-19. After a few hours, he developed cardiogenic shock.
- A 75-year-old man did not have any cardiovascular risk factors and was admitted due to dyspnea, chest pain, and bilateral SARS-CoV-2 pneumonia.
- A 37-year-old woman, obese with a history of deep venous thrombosis, had symptoms of dyspnea and chest pain
Physical Examination
- Patients with [disease name] usually appear [general appearance].
- Physical examination may be remarkable for:
- [finding 1]
- [finding 2]
- [finding 3]
- [finding 4]
- [finding 5]
- [finding 6]
Laboratory Findings
- There are no specific laboratory findings associated with [disease name].
- A [positive/negative] [test name] is diagnostic of [disease name].
- An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
- Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
Imaging Findings
- There are no [imaging study] findings associated with [disease name].
- [Imaging study 1] is the imaging modality of choice for [disease name].
- On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
- [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- [Disease name] may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- There is no treatment for [disease name]; the mainstay of therapy is supportive care.
- The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
- [Medical therapy 1] acts by [mechanism of action 1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
Surgery
- Surgery is the mainstay of therapy for [disease name].
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
- [Surgical procedure] can only be performed for patients with [disease stage] [disease name].
Prevention
- There are no primary preventive measures available for [disease name].
- Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
References
- ↑ 1.0 1.1 1.2 Tavazzi, Guido; Pellegrini, Carlo; Maurelli, Marco; Belliato, Mirko; Sciutti, Fabio; Bottazzi, Andrea; Sepe, Paola Alessandra; Resasco, Tullia; Camporotondo, Rita; Bruno, Raffaele; Baldanti, Fausto; Paolucci, Stefania; Pelenghi, Stefano; Iotti, Giorgio Antonio; Mojoli, Francesco; Arbustini, Eloisa (2020). "Myocardial localization of coronavirus in COVID‐19 cardiogenic shock". European Journal of Heart Failure. 22 (5): 911–915. doi:10.1002/ejhf.1828. ISSN 1388-9842.
- ↑ Siddiqi, Hasan K.; Mehra, Mandeep R. (2020). "COVID-19 illness in native and immunosuppressed states: A clinical–therapeutic staging proposal". The Journal of Heart and Lung Transplantation. 39 (5): 405–407. doi:10.1016/j.healun.2020.03.012. ISSN 1053-2498.
- ↑ 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.
- ↑ Boukhris, Marouane; Hillani, Ali; Moroni, Francesco; Annabi, Mohamed Salah; Addad, Faouzi; Ribeiro, Marcelo Harada; Mansour, Samer; Zhao, Xiaohui; Ybarra, Luiz Fernando; Abbate, Antonio; Vilca, Luz Maria; Azzalini, Lorenzo (2020). "Cardiovascular Implications of the COVID-19 Pandemic: A Global Perspective". Canadian Journal of Cardiology. doi:10.1016/j.cjca.2020.05.018. ISSN 0828-282X.
- ↑ Rajagopal, Keshava; Keller, Steven P.; Akkanti, Bindu; Bime, Christian; Loyalka, Pranav; Cheema, Faisal H.; Zwischenberger, Joseph B.; El Banayosy, Aly; Pappalardo, Federico; Slaughter, Mark S.; Slepian, Marvin J. (2020). "Advanced Pulmonary and Cardiac Support of COVID-19 Patients". Circulation: Heart Failure. 13 (5). doi:10.1161/CIRCHEARTFAILURE.120.007175. ISSN 1941-3289.
- ↑ 6.0 6.1 Sánchez-Recalde, Ángel; Solano-López, Jorge; Miguelena-Hycka, Javier; Martín-Pinacho, Jesús Javier; Sanmartín, Marcelo; Zamorano, José L. (2020). "COVID-19 and cardiogenic shock. Different cardiovascular presentations with high mortality". Revista Española de Cardiología (English Edition). doi:10.1016/j.rec.2020.04.012. ISSN 1885-5857.
- ↑ Mahajan, Kunal; Chandra, K.Sarat (2020). "Cardiovascular comorbidities and complications associated with coronavirus disease 2019". Medical Journal Armed Forces India. doi:10.1016/j.mjafi.2020.05.004. ISSN 0377-1237.
- ↑ Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H; et al. (2020). "Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study". Lancet Respir Med. 8 (5): 475–481. doi:10.1016/S2213-2600(20)30079-5. PMC 7102538 Check
|pmc=value (help). PMID 32105632 Check|pmid=value (help). - ↑ Takahashi M, Arai H, Kokubo T, Furukawa F, Kurata Y, Ito N (1980). "An ultrastructural study of precancerous and cancerous lesions of the pancreas in Syrian golden hamsters induced by N-nitrosobis(2-oxopropyl)amine". Gan. 71 (6): 825–31. PMID 7274628.