How are acute cardiac complications managed in patients with coronavirus disease 2019 (COVID-19)?

Updated: Jul 01, 2020
  • Author: Medscape Drugs & Diseases; more...
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Make plans to quickly identify and isolate cardiovascular patients with coronavirus disease 2019 (COVID-19) symptoms from other patients, including in the ambulatory setting. [12]

COVID-19–related cardiac complications include arrhythmia and acute cardiac injury. [12]

Conditions that can precipitate cardiac complications include acute-onset heart failure, myocardial infarction, myocarditis, and cardiac arrest, as well as any illness that places a higher cardiometabolic demand on patients. [12]

COVID-19 cardiac complications appear in line with severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and influenza analogs. [12]

Cardiologists should prepare to aid other specialists in managing cardiac complications in patients with severe COVID-19. [12]

Cardiology and critical-care teams should coordinate management of patients requiring extracorporeal circulatory support with veno-venous (V-V) versus veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO). [12]

Obtain echocardiography in the setting of heart failure, arrhythmia, electrocardiographic (ECG) changes, or cardiomegaly. [12]

It is reasonable to triage patients with COVID-19 according to the presence of underlying cardiovascular, diabetic, respiratory, renal, oncologic, and other chronic diseases for prioritized treatment. [12]

Providers are cautioned that classic symptoms and presentation of acute myocardial infarction may be overshadowed in the context of COVID-19, resulting in underdiagnosis. [12]

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