Apical Takotasobo Cardiomyopathy Post-Covid Pneumonia Associated with Changeable Bifascicular Block Volume 4 - Issue 2

Yasser Mohammed Hassanain Elsayed?¹*

• ¹Critical Care Unit, Al-Rodah Central Hospital, Damietta Health Affairs, Egyptian Ministry of Health (MOH), Damietta, Egypt

Received:April 08, 2021;  Published: May 04, 2021

Corresponding author: Yasser Mohammed Hassanain Elsayed, Critical Care Unit, Al-Rodah Central Hospital, Damietta Health Affairs, Egyptian Ministry of Health (MOH), Damietta, Egypt

DOI: 10.32474/GJAPM.2021.04.000186

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Abstract

Rationale: A novel COVID-19 with severe acute respiratory syndrome had emerged in Wuhan, China in December 2019. The presence of takotasobo cardiomyopathy in COVID-19 patients is an extremely rare and commonly recognized post severe stress. The changeable bifascicular block is also very rare to be present after COVID-19 with the severe acute respiratory syndrome. Interestingly, the combination of COVID-19 pneumonia with an apical takotasobo cardiomyopathy and changeable bifascicular block has a worthy risk impact on both morbidity and mortality of COVID-19 patients. Patient concerns: An elderly carpenter male COVID-19 pneumonic patient was admitted to the critical care unit with dyspnea and tachypnea post-severe emotional stress with evidence of acute myocardial infarction, cardiomyopathy, and changeable bifascicular block. Diagnosis: Apical takotasobo cardiomyopathy post- COVID pneumonia associated with changeable bifascicular block. Interventions: Chest CT scan, electrocardiography, oxygenation, and echocardiography. Outcomes: Gradual clinical, and radiological improvement had happened. Lessons: An apical ballooning after emotional stress in recent COVID pneumonia is an indicator for apical takotasobo cardiomyopathy. The S-T segment elevations with non-specific T-wave inversions and changeable bifascicular block in apical ballooning may be a hallmark for the existence of apical takotasobo cardiomyopathy. The changeable non-specific T-wave inversions and bifascicular block is a recommended interesting issue for further wide-study.

Keywords: COVID-19; Coronavirus; Pneumonia; Takotasobo cardiomyopathy; Changeable bifascicular block; Heart block

Abbreviations:ACS: Acute Coronary Syndrome, CBC: Complete Blood Count, COVID-19: Coronavirus Disease 2019, ECG: Electrocardiography, IHD: Ischemic Heart Disease, IV: Intravenous, IVB: Intravenous Bolus, LAFB: Left Anterior Fascicular Block, LBBB: Left Bundle Branch Block, LPFB: Left Posterior Fascicular Block, LV: Left Ventricular, O2: Oxygen, RBBB: Right Bundle Branch Block, SGOT: Serum Glutamic-Oxaloacetic Transaminase, SGPT: Serum Glutamic-Pyruvic Transaminase, TTC: Takotsubo Cardiomyopathy, VR: Ventricular Rate

Abstract| Introduction| Case Presentation| Discussion| Conclusion and Recommendation| Conflicts of Interest| Acknowledgment| References|