Practical Approach to Acute Coronary Syndrome in Patients with COVID-19
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | International Journal of Cardiovascular Sciences (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472021000100089 |
Resumo: | Abstract Acute cardiac injury is associated with higher mortality in patients with the novel coronavirus disease-2019 (COVID-19) and the exact etiology can be challenging to diagnose in the emergency setting during the pandemic. From a pathophysiological perspective, SARS-CoV-2 infection is characterized by an overproduction of inflammatory cytokines (IL-6, TNF-alpha) that leads to systemic inflammation and consequent increased risk of acute myocardial infarction (AMI) caused by atheromatous plaque rupture and significant myocardial oxygen supply-demand imbalance. Moreover, SARS-CoV-2 tropism to the renin-angiotensin-aldosterone system through the ACE2 receptor induces myocarditis that may rapidly progress to left ventricular dysfunction and hemodynamic instability. Myocardial inflammation with pericardial involvement, i.e. , myopericarditis, can progress to cardiac tamponade and obstructive shock. These cardiovascular complications, which are associated with a worse prognosis and higher mortality, can be associated with clinical manifestations, electrocardiographic changes, and troponin values similar to AMI. Thus, the diagnosis and treatment of patients with acute chest pain and dyspnea admitted to the emergency department is a significant challenge during the COVID-19 pandemic. Here, we provide a review of the literature focusing on a practical approach to acute coronary syndrome patients with confirmed or suspected COVID-19. |
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Practical Approach to Acute Coronary Syndrome in Patients with COVID-19Acute Coronary SyndromeBetacoronavirusCOVID-19InfectionPandemicsTroponinElectrocardiography/methodsAbstract Acute cardiac injury is associated with higher mortality in patients with the novel coronavirus disease-2019 (COVID-19) and the exact etiology can be challenging to diagnose in the emergency setting during the pandemic. From a pathophysiological perspective, SARS-CoV-2 infection is characterized by an overproduction of inflammatory cytokines (IL-6, TNF-alpha) that leads to systemic inflammation and consequent increased risk of acute myocardial infarction (AMI) caused by atheromatous plaque rupture and significant myocardial oxygen supply-demand imbalance. Moreover, SARS-CoV-2 tropism to the renin-angiotensin-aldosterone system through the ACE2 receptor induces myocarditis that may rapidly progress to left ventricular dysfunction and hemodynamic instability. Myocardial inflammation with pericardial involvement, i.e. , myopericarditis, can progress to cardiac tamponade and obstructive shock. These cardiovascular complications, which are associated with a worse prognosis and higher mortality, can be associated with clinical manifestations, electrocardiographic changes, and troponin values similar to AMI. Thus, the diagnosis and treatment of patients with acute chest pain and dyspnea admitted to the emergency department is a significant challenge during the COVID-19 pandemic. Here, we provide a review of the literature focusing on a practical approach to acute coronary syndrome patients with confirmed or suspected COVID-19.Sociedade Brasileira de Cardiologia2021-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472021000100089International Journal of Cardiovascular Sciences v.34 n.1 2021reponame:International Journal of Cardiovascular Sciences (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.36660/ijcs.20200150info:eu-repo/semantics/openAccessAzevedo,Rafael BellottiBotelho,Bruna GoppHollanda,João Victor Gonçalves deFerreira,Leonardo Villa LeãoAndrade,Letícia Zarur Junqueira deOei,Stephanie Si Min LilienwaldMello,Tomás de SouzaMuxfeldt,Elizabeth Silaideng2022-02-02T00:00:00Zoai:scielo:S2359-56472021000100089Revistahttp://publicacoes.cardiol.br/portal/ijcshttps://old.scielo.br/oai/scielo-oai.phptailanerodrigues@cardiol.br||revistaijcs@cardiol.br2359-56472359-4802opendoar:2022-02-02T00:00International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC)false |
dc.title.none.fl_str_mv |
Practical Approach to Acute Coronary Syndrome in Patients with COVID-19 |
title |
Practical Approach to Acute Coronary Syndrome in Patients with COVID-19 |
spellingShingle |
Practical Approach to Acute Coronary Syndrome in Patients with COVID-19 Azevedo,Rafael Bellotti Acute Coronary Syndrome Betacoronavirus COVID-19 Infection Pandemics Troponin Electrocardiography/methods |
title_short |
Practical Approach to Acute Coronary Syndrome in Patients with COVID-19 |
title_full |
Practical Approach to Acute Coronary Syndrome in Patients with COVID-19 |
title_fullStr |
Practical Approach to Acute Coronary Syndrome in Patients with COVID-19 |
title_full_unstemmed |
Practical Approach to Acute Coronary Syndrome in Patients with COVID-19 |
title_sort |
Practical Approach to Acute Coronary Syndrome in Patients with COVID-19 |
author |
Azevedo,Rafael Bellotti |
author_facet |
Azevedo,Rafael Bellotti Botelho,Bruna Gopp Hollanda,João Victor Gonçalves de Ferreira,Leonardo Villa Leão Andrade,Letícia Zarur Junqueira de Oei,Stephanie Si Min Lilienwald Mello,Tomás de Souza Muxfeldt,Elizabeth Silaid |
author_role |
author |
author2 |
Botelho,Bruna Gopp Hollanda,João Victor Gonçalves de Ferreira,Leonardo Villa Leão Andrade,Letícia Zarur Junqueira de Oei,Stephanie Si Min Lilienwald Mello,Tomás de Souza Muxfeldt,Elizabeth Silaid |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Azevedo,Rafael Bellotti Botelho,Bruna Gopp Hollanda,João Victor Gonçalves de Ferreira,Leonardo Villa Leão Andrade,Letícia Zarur Junqueira de Oei,Stephanie Si Min Lilienwald Mello,Tomás de Souza Muxfeldt,Elizabeth Silaid |
dc.subject.por.fl_str_mv |
Acute Coronary Syndrome Betacoronavirus COVID-19 Infection Pandemics Troponin Electrocardiography/methods |
topic |
Acute Coronary Syndrome Betacoronavirus COVID-19 Infection Pandemics Troponin Electrocardiography/methods |
description |
Abstract Acute cardiac injury is associated with higher mortality in patients with the novel coronavirus disease-2019 (COVID-19) and the exact etiology can be challenging to diagnose in the emergency setting during the pandemic. From a pathophysiological perspective, SARS-CoV-2 infection is characterized by an overproduction of inflammatory cytokines (IL-6, TNF-alpha) that leads to systemic inflammation and consequent increased risk of acute myocardial infarction (AMI) caused by atheromatous plaque rupture and significant myocardial oxygen supply-demand imbalance. Moreover, SARS-CoV-2 tropism to the renin-angiotensin-aldosterone system through the ACE2 receptor induces myocarditis that may rapidly progress to left ventricular dysfunction and hemodynamic instability. Myocardial inflammation with pericardial involvement, i.e. , myopericarditis, can progress to cardiac tamponade and obstructive shock. These cardiovascular complications, which are associated with a worse prognosis and higher mortality, can be associated with clinical manifestations, electrocardiographic changes, and troponin values similar to AMI. Thus, the diagnosis and treatment of patients with acute chest pain and dyspnea admitted to the emergency department is a significant challenge during the COVID-19 pandemic. Here, we provide a review of the literature focusing on a practical approach to acute coronary syndrome patients with confirmed or suspected COVID-19. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472021000100089 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472021000100089 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.36660/ijcs.20200150 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia |
dc.source.none.fl_str_mv |
International Journal of Cardiovascular Sciences v.34 n.1 2021 reponame:International Journal of Cardiovascular Sciences (Online) instname:Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
instname_str |
Sociedade Brasileira de Cardiologia (SBC) |
instacron_str |
SBC |
institution |
SBC |
reponame_str |
International Journal of Cardiovascular Sciences (Online) |
collection |
International Journal of Cardiovascular Sciences (Online) |
repository.name.fl_str_mv |
International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC) |
repository.mail.fl_str_mv |
tailanerodrigues@cardiol.br||revistaijcs@cardiol.br |
_version_ |
1754732627420512256 |