Long COVID Syndrome and Takotsubo Cardiomyopathy: An Unwelcome Combination

Abstract

Since the report of the first case from China in late 2019, the coronavirus disease (COVID-19) has spread very rapidly through the countries and regions leaving a trail of devastation in its path, everywhere. Although COVID-19 is primarily a respiratory illness mainly affecting the lungs; involvement of other organs including the cardiovascular system has been widely recognized. Whilst COVID-19 is an acute illness for a majority of cases; some of the debilitating virus-related symptoms can last for weeks and months, and are collectively termed as long COVID syndrome. Several published reports have described an association between acute COVID-19 illness and cardiac complications such as myocarditis and Takotsubo cardiomyopathy. However, little is known about any link between long COVID syndrome and the cardiac disease. We describe the case of a middle-aged woman with long COVID syndrome who presented with central chest pain and breathlessness. Her initial investigations showed an elevated cardiac troponin I and ischemic changes on 12 lead ECG. She was initially treated for non-ST elevation myocardial infarction. A subsequent coronary angiogram showed unobstructed coronary vessels and left ventricle (LV) gram demonstrated apical LV ballooning. She was managed conservatively and was discharged home following her clinical improvement. This case highlights the importance of holistic assessment of patients presenting with chest pain with the background of long COVID syndrome. It also outlines an emergent need to better understand pathophysiological mechanisms that underpin the development of cardiac complications in those with COVID-19 and long COVID syndrome.

Trends in occurrence of takotsubo syndrome and association with SARS-CoV-2 infection and COVID-19 vaccination

“…Even though case reports are an important tool for detecting novel findings, they also have significant limitations, including lack of a control group, small numbers of patients, limited generalizability, and publication bias. The present study has several limitations; recent case reports described possible occurrence of TTS as part of long COVID-19 syndrome 33,34 . However, our study evaluated TTS occurrence following the infection and vaccination within 30 and 60 days and thus did not fully address long COVID-19 syndrome.…”

“…The present study has several limitations; recent case reports described possible occurrence of TTS as part of long COVID-19 syndrome. 33,34 However, our study evaluated TTS occurrence following the infection and vaccination within 30 and 60 days and thus did not fully address long COVID-19 syndrome. As with any retrospective study that is based on data from a clinical and administrative database, a possible limitation may be related to the completeness and the accuracy of data.…”

Analysis of the Effectiveness of Nursing Interventions in Critically Ill Patients in Respiratory Medicine

“…Since China reported its first case at the end of 2019, the coronavirus disease (COVID-19) has spread rapidly in various countries and regions, leaving devastating traces on its transmission path, everywhere. COVID-19 is mainly a respiratory disease that mainly affects the lungs; the involvement of other organs, including the cardiovascular system, has been widely recognized [ 6 ].…”