Severe short-lasting left ventricular dysfunction associated with a respiratory infection

Abstract

Introduction Since clinical and electrocardiographic features of various cardiac disorders may overlap, the differential diagnosis of left ventricular (LV) dysfunction may be difficult even for the most experienced physicians. Recent advances in cardiac imaging may help clinicians to establish an accurate diagnosis and initiate adequate treatment. The aim of this case report is to raise awareness of a very short-lasting LV dysfunction during respiratory infections and to underline the importance of multimodality imaging in this clinical setting. Case outline A previously healthy 37-year-old male presented with atypical chest pain and ST-segment elevation in the inferolateral leads during severe mental stress and acute respiratory infection. Acute myocardial infarction, myocarditis, coronary vasospasm and stress cardiomyopathy were all considered as a differential diagnosis. A rapid onset of severe LV dysfunction and a complete recovery within 4 days was detected by echocardiography and further evaluated by multimodality imaging, including multislice computed tomography and cardiac magnetic resonance imaging. Conclusion Severe, but very short-lasting LV dysfunction may be triggered by various causes, including upper respiratory tract infections. Since the symptoms of respiratory infections may obscure those of LV dysfunction, myocardial dysfunction in these patients may go undetected with possible serious consequences.

ECHOS survey on echocardiography in Serbia during the COVID-19 pandemic

“…The novel coronavirus 2019, or severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that results in COVID-19 has reached pandemic level in March 2020[1].During the pandemic in Serbia, several hospitals were turned into specialized centers and have been providing care only to confirmed COVID-19 patients, while the remaining centers continued providing health services, including echocardiography, to presumably COVID-19 negative patients.Apart from causing pneumonia, SARS-CoV-2 may also affect cardiovascular (CV) system, resulting in worse prognosis[2]. Consequently, in COVID-19 centers, a clinical suspicion of CV involvement in patients with severe COVID -19 disease is likely to trigger cardiac diagnostic work-up that typically includes echocardiography, as it was the case with other respiratory viruses in the past[3].Cardiologists and other HCP performing echocardiography at both COVID and non-COVID-19 centers were at risk of getting infected and the availability of personal protective equipment (PPE) and the training on its proper use were of paramount importance to minimize the risk of infection [4, 5, 6]. The aim of the current Echocardiographic Society of Serbia (ECHOS) survey was to assess the usage of echocardiography and the availability of PPE during the pandemic in Serbia, in both COVID and non-COVID-19 centers.…”