Less is More: Managing Non-Sustained Ventricular Tachycardia in a Patient with SARS-CoV2 Infection

Paul Madaj¹, Lu Chen^{2, 3}, Yuvraj Singh Choudhury¹, Robert M Donnino⁴ and Cristina A Mitre^3,

¹Division of Cardiovascular Medicine, Department of Medicine, State University of New York, Downstate Medical Center- Brooklyn, NY 11203

²Department of Medicine, State University of New York, Downstate Medical Center- Brooklyn, NY 11203

³Division of Cardiology, Department of Medicine, Veteran Affairs New York Harbor Healthcare System, Brooklyn Campus, Brooklyn, NY 11209

⁴Division of Cardiology, Department of Medicine, Veteran Affairs New York Harbor Healthcare System, Manhattan Campus, New York, NY and Department of Cardiology, New York University, School of Medicine 10010

Cite this paper

Paul Madaj, Lu Chen, Yuvraj Singh Choudhury, Robert M Donnino and Cristina A Mitre. Less is More: Managing Non-Sustained Ventricular Tachycardia in a Patient with SARS-CoV2 Infection. American Journal of Medical Case Reports. 2020; 8(11):389-393. doi: 10.12691/AJMCR-8-11-3

Abstract

The novel coronavirus disease 2019 (COVID-19) has changed our lives and reshaped our approach to management of various cardiovascular diseases. Ventricular tachycardia (VT) is a potentially life-threatening arrhythmia, most often seen in patients with structural heart disease. If underlying ischemia is suspected, coronary angiography is usually performed on a non-elective basis. In patients with active COVID-19, additional risks of the procedure must be considered for patients and for operators. This case illustrates the management of suspected ischemic VT and discusses the dilemma physicians must face in the ongoing COVID-19 pandemic.

Keywords

ventricular tachycardia, novel coronavirus, COVID, coronary artery disease, ischemic injury

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020 Apr.
[2]	Chen L, Upadhya G, Guo US, Belligund P, Lee DK, Shalom I, et al. Novel Coronavirus-Induced Right Ventricular Failure and Point of Care Echocardiography: A Case Report. Cardiology. 2020 May; 1-6.
[3]	Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 2020 Mar.
[4]	Chen C, Chen C, Yan JT, Zhou N, Zhao JP, Wang DW. [Analysis of myocardial injury in patients with COVID-19 and association between concomitant cardiovascular diseases and severity of COVID-19]. Zhonghua Xin Xue Guan Bing Za Zhi. 2020 Mar; 48(0): E008.
[5]	Lakkireddy DR, Chung MK, Gopinathannair R, Patton KK, Gluckman TJ, Turagam M, et al. Guidance for Cardiac Electrophysiology During the Coronavirus (COVID-19) Pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association. Heart Rhythm. 2020 Apr.
[6]	Shivkumar K. Catheter Ablation of Ventricular Arrhythmias. N Engl J Med. 2019 18; 380(16): 1555-64.
[7]	Ranard LS, Ahmad Y, Masoumi A, Chuich T, Romney M-LS, Gavin N, et al. Clinical Pathway for Management of Suspected or Positive Novel Coronavirus-19 Patients With ST-Segment Elevation Myocardial Infarction. Crit Pathw Cardiol. 2020; 19(2): 49-54.
[8]	Jing Z-C, Zhu H-D, Yan X-W, Chai W-Z, Zhang S. Recommendations from the Peking Union Medical College Hospital for the management of acute myocardial infarction during the COVID-19 outbreak. Eur Heart J. 2020 May; 41(19): 1791-4.
[9]	The American Heart Association’s Get With The Guidelines-Coronary Artery Disease Advisory Work Group And Mission Lifeline Program null, The American Heart Association’s Council On Clinical Cardiology null, The American Heart Association’s Council On Clinical Cardiology’s Committee On Acute Cardiac Care And General Cardiology Committee null, The American Heart Association’s Council On Clinical Cardiology’s Committee Interventional Cardiovascular Care Committee null. Temporary Emergency Guidance to STEMI Systems of Care During the COVID-19 Pandemic: AHA’s Mission: Lifeline. Circulation. 2020 May.
[10]	Welt FGP, Shah PB, Aronow HD, Bortnick AE, Henry TD, Sherwood MW, et al. Catheterization Laboratory Considerations During the Coronavirus (COVID-19) Pandemic: From the ACC’s Interventional Council and SCAI. J Am Coll Cardiol. 2020 May; 75(18): 2372-5.
[11]	Saeed M, Liu H, Liang C-H, Wilson MW. Magnetic resonance imaging for characterizing myocardial diseases. Int J Cardiovasc Imaging. 2017 Sep; 33(9): 1395-414.
[12]	Pei G, Zhang Z, Peng J, Liu L, Zhang C, Yu C, et al. Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia. J Am Soc Nephrol JASN. 2020 Apr.
[13]	Szerlip M, Anwaruddin S, Aronow HD, Cohen MG, Daniels MJ, Dehghani P, et al. Considerations for cardiac catheterization laboratory procedures during the COVID-19 pandemic perspectives from the Society for Cardiovascular Angiography and Interventions Emerging Leader Mentorship (SCAI ELM) Members and Graduates. Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv. 2020 Mar..