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. 2023 Apr 30;75:36. doi: 10.1186/s43044-023-00359-0
Cases Demographics Clinical symptoms Signs Diagnostic tests Treatment and prognosis Prognosis References
1

73-year-old female

Caucasian

Altered mental status, panic attack with palpitations, nausea, numbness, tachypnea, heavy breathing, dry cough, and chest discomfort

BP 137/71

O2 sat 83%

Tem:99.7°F

HR ~ 115

RR ~ 33

Tachycardia,

Irregular rhythm

Pulse deficit

Bibasilar crackles

CXR: Diffuse pulmonary edema, bilateral interstitial infiltrates, and hazy opacities

ECG: atrial fibrillation with RVR

CT Scan: multiple ground glass opacities predominantly in peripherally and posteriorly

Supportive care, Dexamethasone, Hydroxychloroquine, Remdesivir, Anticoagulation, azithromycin Clinical recovery to sinus rhythm [49]
2 66-year-old female On 6th day of COVID-19 related admission patient presented with tachycardia and palpitations HR: 160 bpm EKG showed atrial fibrillation with rapid ventricular response

Metoprolol

Diltiazem

Carvedilol

Clinical recovery to sinus rhythm [50]
3 66-year-old male Sudden onset of palpitations and worsening dyspnea

HR: 186

BP: 134/80

EKG showed irregular, narrow-QRS complex tachycardia without P waves

Amiodarone

External Electric shock 260 J

Brainstem acute ischemic stroke, ventricular fibrillation and cardiac arrest [51]
4 90-year-old African American female Altered mental status from welfare check

BP 141/78

Tem:97.9°F

HR ~ 140

RR ~ 44

ECG: atrial fibrillation with RVR

Echo: Ejection fraction 65–70% with grade I diastolic dysfunction

Intubation, supportive care, Hydroxychloroquine

azithromycin

Clinical recovery to sinus rhythm [52]
5 50-year-old male Pain on the posterior aspect of the right lower leg

BP 129/76

Tem:98.9°F

HR ~ 78

RR ~ 18

EKG showed irregular heart rate with new-onset AF

CT scan extremities: partial right popliteal block

CT abdomen: Left kidney lower pole infarction

MRA: Right occipital lobe subacute infarcts

Inpatient: Azithromycin, oseltamivir, paracetamol, Vitamin C, zinc sulfate, Hydroxychloroquine

Bisoprolol and Omeprazole. Outpatient: Direct acting oral anticoagulant (DOAC), atorvastatin, aspirin and bisoprolol

Follow-up with AF clinic for electric cardioversion

Clinical recovery to sinus rhythm [53]
6 72-year-old female Altered mental status

HR ~ 133

Tachypnea

Leukocytosis

Increased lactate

EKG New-onset AF with RVR

Troponins: > 20,000 ng without ST and T elevations suggesting acute cardiac ischemia

Cardizem drip followed by oral amiodarone and metoprolol Clinical recovery to sinus rhythm [54]
7 57-year-old male Palpitations and progressive dyspnea

BP 117/97

O2 sat 97%

HR ~ 152

RR ~ 14

Irregularly irregular puse

Bibasilar fine crepitations

Elevated JVP

EKG New-onset AF

Echo: LVEF 20% and MR

Cardiac MRI: biventricular edema, dysfunction with LVEF 30%. Severe myocarditis

Intravenous diuretics, rate control agents, anticoagulation, ACE inhibitor and mineralocorticoid Clinical recovery. Cardiac MRI at 3-month interval planned with outpatient follow-up [55]
8 78-year-old Caucasian male Altered mental status, panic attack, palpitations, nausea, numbness, tachypnea, heavy breathing, dry cough and chest discomfort

BP 137/71

O2 sat 83%

Temp 39.7C

HR ~ 115

RR ~ 33

Irregular rhythm

Bibasilar crackles

Pulse deficit

EKG AF with RVR

Anion gap: abnormal

Metabolic alkalosis

Echo: borderline abnormal LVEF (50–55%), LV diastolic dysfunction, mild pericardial effusion, moderate septal hypertrophy, mild dilated LV (LVEDD: 58.9 mm and LVESD: 40.7 mm) and restrictive LV filling pattern

ICU admission, intubation, vasopressor, supportive care, dexamethasone, hydroxychloroquine, remdesevir, IV Ibutilide, anticoagulation and azithromycin Normal sinus rhythm was restored two days prior to extubation [56]
9 72-year-old male Severely hypoxic patient (Sp02 65%) Irregular heart rhythm, exhausted, perspiring, bilateral medium crackles,

EKG: AF

Echo: Globally reduced LV systolic function, EF 30%

Intubation, Non-adrenaline, Dobutamine, Volume resuscitation, Argipressin, Dexamethasone, Landiolol, amiodarone, digitoxin, ivabradine and Levosimandan

Pericardial tamponade

Cardiogenic shock

Death

[57]
10 18 y male Refractory hypotension, blurry vision, eye redness, nausea, vomiting, cheat pain, nausea, vomiting, syncope, dizziness and refractory hypotension

BP 80/40

HR ~ 120

Hepatomegaly

Injected conjunctiva

Erythematous tongue

Blanching rash on palm and wrists

EKG: AF, wide complex tachycardia

Echo: mild pericardial effusion

Cardioversion 100–150 J

Bolus of Amiodarone

Low dose epinephrine

Normal sinus rhythm is restored with complete clinical recovery [58]
11 15-year-old African American female Headache, vomiting and fatigue

BP 70/90

Temp 102.8 F

HR ~ 150

Echo: Severe LV dysfunction without atrial or ventricular dilation

EKG: AF with RVR

IV saline, milrinone, epinephrine, IV immunoglobulin, IV methyl prednisolone, subcutaneous LMW heparin, IL-1 receptor antagonist (Anakinra). Cardioversion (50 J) and Amiodarone Normal sinus rhythm is restored with complete clinical recovery [59]