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] |