Tag Archives: COVID-19

Introduction The COVID-19 pandemic has posed a serious threat to global health worldwide. In an acute disease process, which is the case in COVID-19, electrocardiography (ECG) abnormalities are common, present in up to 93% of hospitalised critically ill patients.1 Any specific ECG alteration criteria could help emergency clinicians establish the prognosis and assess the risk of adverse events resulting from coronavirus infection. The purpose of this meta-analysis was to assess the prognostic value of the admission ECG (specifically: the duration of the PR interval, the QTc interval and the QRS complex and the heart rate [HR]) in COVID-19 pati

Background Ambulatory electrocardiogram (AECG) monitoring is a common investigation performed as part of the assessment of patients with known or suspected cardiac arrhythmias. This normally requires the patient to attend a face-to-face hospital appointment. The role of patient-led collection and self-fitting of AECG within the National Health Service (NHS) has not previously been investigated. In order to reduce patient contact during the COVID-19 pandemic, and in order to maintain AECG services while other non-urgent diagnostics were suspended, we sought to assess the feasibility, reliability, and patient acceptability of a drive-by collect

While the aetiology of this complex condition remains unclear, PoTS has been associated with other conditions, including the Epstein-Barr virus, autoimmune conditions1 such as Sjögren’s syndrome and antiphospholipid syndrome, joint hypermobility conditions,2 and chronic fatigue.3 PoTS, as is the case for most syndromes, presents uniquely in everyone in terms of its thumbprint of symptomatic expression. Similarly, these post-COVID-19 cases, in addition to the diagnostic presence of abnormal response by the autonomic nervous system to upright posture (diagnosed by a sustained increase in heart rate of over 30 bpm in adults within 10 minutes

Introduction Postural tachycardia syndrome (PoTS) was first described in American Civil War soldiers,1 and subsequently in First World War soldiers.2 These early descriptions were published by some of the most eminent cardiologists of the time. It was defined formally as a syndrome in 1993,3 leading onto guidelines, more recently published by the Heart Rhythm Society 2015,4 and the Canadian Cardiovascular Society 2020.5 While we remain uncertain in detail about its underlying cause, it seems to be an abnormality in the regulation of the cardiovascular system causing excessive tachycardia on standing, with cardiovascular symptoms including ch

Introduction Delays in treatment following ST-elevation myocardial infarction (STEMI) influence patient outcomes. During the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) pandemic, delays in treatment may have altered outcomes of STEMI patients, even in those not infected by COVID-19. On 11 March 2020, the World Health Organisation declared COVID-19 a global pandemic.1 The UK government mandated social distancing on 16 March 2020, and imposed a nationwide lockdown on 23 March 2020.2 Primary percutaneous coronary intervention (PCI) remained our centre’s treatment of choice for STEMI, with thrombolys

Introduction Performing a transthoracic echocardiogram (TTE) usually involves an echocardiographer and a patient spending about 30 minutes in close proximity. This presents a risk for COVID-19 transmission for them both. In March 2020, at the start of the COVID-19 pandemic, the British Society of Echocardiography (BSE) released guidance about inpatient scanning advocating triage of requests, targeted scanning and use of personal protective equipment (PPE).1 Their subsequent COVID-19 recovery advice relating to outpatient services outlined risk mitigation and performing ‘as focused a study as the referral allows’ if the patient had been sc

Introduction From December 2019, SARS-CoV-2, a novel coronavirus, sparked a global pandemic and rapid scientific responses to the new coronavirus 2019 (COVID-19) disease. Rapid identification showed the angiotensin-converting enzyme 2 (ACE-2) as the host receptor for SARS-CoV-2. Given this, concerns were raised that renin–angiotensin–aldosterone system (RAAS) inhibitors, such as ACE inhibitors and angiotensin-receptor blockers (ARBs), which may increase the expression of ACE‑2, could negatively influence COVID-19 outcomes. This led to significant media attention and anxiety about ongoing use of these medications. However, there has bee

Introduction The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan China and has since spread to over 180 countries.1 It was declared a pandemic by the World Health Organization (WHO) in March 2020. In addition to the common respiratory clinical presentation, COVID-19 is associated with cardiovascular complications, which may contribute to patients’ demise.2 The most common is myocardial injury, indicated by a serum troponin rise, which has also been found to be a reliable indicator of disease severity.3 Cardiac arrhythmia is another common cardiovascular manifestati

Introduction During the COVID-19 pandemic, difficult decisions have had to be made about access to a wide range of therapies and procedures. On 17 March 2020, National Health Service (NHS) bodies were instructed to create capacity to manage an expected surge of COVID-19 cases, and this included stopping all elective procedures by 15 April.1 Guidelines for triage of patients left those awaiting a primary prevention implantable cardioverter-defibrillator (ICD) in a grey area: a case-by-case decision should be made, but that these procedures could be reasonably delayed.2 It has recently been highlighted that patients awaiting a primary preventio

Introduction SARS-CoV-2 has rapidly become a worldwide health emergency. The declaration by the World Health Organisation (WHO) in March 2020 of a global pandemic has underscored the widespread morbidity and mortality caused by the virus. Concerted efforts by healthcare and research communities are ongoing to establish the efficacy and potency of various pharmacotherapeutics. It has been shown that coronavirus disease 2019 (COVID-19) affects multiple organs and has heterogeneous effects on the cardiovascular system. This is also accompanied by enhanced morbidity and mortality in patients with pre-existing cardiovascular disease.1 In urgent e