MedStar Investigators Report on Myocardial Injury from COVID-19

MedStar Health researchers published a report highlighting two cases of COVID-19 infection with myocardial involvement with distinct mechanistic pathways and outcomes. The cases discussed the important decision strategies for these critically ill patients, such as the timing of cardiac catheterization (when indicated) and requirement of early hemodynamic support. “COVID-19 (SARS-Cov-2) and the heart – An ominous association” was published in Cardiovascular Revascularization Medicine.

Cardiovascular manifestations of COVID-19 can be diverse and complex, including myocardial injury, infarction, myocarditis simulating ST-segment elevation myocardial infarction, non-ischemic cardiomyopathy, coronary vasospasm, pericarditis, or stress(takotsubo) cardiomyopathy.  The publication discussed that based on the initial experience from Wuhan, China, that approximately 27.8% (52/187) of patients with COVID-19 exhibited myocardial injury. Myocardial injury was associated with worse out-comes of COVID-19, whereas the prognosis of patients with underlying cardiovascular disease but without myocardial injury was comparatively favorable.

The cases described in this report are patients with COVID-19 infection and myocardial involvement. The authors indicated that during the COVID-19 pandemic, management of patients with acute coronary syndrome and COVID-19 remains critically important.  Underlying cardiovascular disease and associated risk factors such as hypertension, coronary heart disease, and cardiomyopathy put patients at higher risk of developing myocardial injury during the course of their COVID-19 infection.

The team included Nauman Khalid, MD; Yuefeng Chen MD, PhD; Brian C. Case, MD; Evan Shlofmitz, DO; Jason P. Wermers, Toby Rogers, MD, PhD; Itsik Ben-Dor, MD; and Ron Waksman, MD.

Cardiovascular Revascularization Medicine, 2020, DOI: 10.1016/j.carrev.2020.05.009