A rare case of cardiogenic shock caused by takotsubo syndrome associated with SARS-CoV-2 infection: The value of echocardiography in the diagnosis and monitoring of the efficacy of extracorporeal membrane oxygenation |
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Authors: | Yiran Luo MM Xianwei Ye MD Lu Zhang MM Yang Yang BD Qin Liang MM |
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Affiliation: | 1. Department of Cardiology Cardiac Function Room, Guizhou Provincial People's Hospital, Guiyang, China;2. Department of Pulmonary and Critical Care Medicine, Guizhou Provincial People's Hospital, Guiyang, China;3. Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Guizhou, Zunyi, China |
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Abstract: | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly invades the respiratory system, but may also cause various cardiovascular complications. We report a rare case of myocarditis associated with SARS-CoV-2 infection. A 61-year-old man was admitted to the hospital with a positive nucleic acid test for SARS-CoV-2. A sudden increase in troponin level (up to .144 ng/mL) was observed on the 8th day after admission. He developed symptoms of heart failure and progressed rapidly to cardiogenic shock. Echocardiography on the same day showed reduced left ventricular ejection fraction, reduced cardiac output, and segmental ventricular wall motion abnormalities. Takotsubo cardiomyopathy associated with SARS-CoV-2 infection was considered based on the typical echocardiography findings. We immediately started veno-arterial extracorporeal membrane oxygenation (VA-ECMO) treatment. The patient was successfully withdrawn from VA-ECMO after 8 days following recovery of ejection fraction to 65% and all indicators qualifying the withdrawal criteria. Echocardiography plays an important role in dynamic monitoring of cardiac changes in such cases and can help determine the timing of extracorporeal membrane oxygenation treatment and withdrawal. |
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Keywords: | extracorporeal membrane oxygenation SARS-CoV-2 Takotsubo syndrome transthoracic echocardiography |
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