Abstract
A novel corona virus (SARS-COV-2) started to spread around the world eventually being declared as a global pandemic crisis by WHO in March,2020. Total number of cases have reached to a staggering 140 million by 17th April, 2021 with sad demise of 4 million of the world population. A few number of patients appear to be suffering from cardiac conductive abnormalities have been noted to be associated with SARS-CoV-2. This case unfolds story of a cardiogenic delirium induced by COVID-19. It’s a roller coaster journey of a 62-year -old gentleman presenting with acute delirium which was later found to be due to low brain tissue perfusion resulting from complete heart block. After ruling out all possible causes for the sudden development of complete heart block we came into conclusion of association of SARS-CoV-2 in the development of complete heart block which retrospectively lead the gentleman to become delirious.
Highlights
After ruling out all possible causes for complete heart block we investigated recent studies and have found evidence of COVID-19 associated cardiac conduction defects along with development of complete heart block [1]
We managed to rule out all possible causes of complete heart block prior to the conclusion of a COVID-19 associated conduction defect
One potential theory is affinity of the coronavirus towards cells that express angiotensin-converting enzyme 2 (ACE2) protein which includes myocardial cells and initiation of the cytokines storm, mediated by abnormal T helper cells and hypoxiainduced high intracellular calcium resulting in cardiac myocyte apoptosis [7]
Summary
A 62-year-old male, usually fit and healthy with no comorbidities was brought to the accident and emergency triage with acute onset delirium. Collateral history from wife revealed he had no prior history of memory impairment On further query she mentioned him suffering from nonproductive cough and intermittent low-grade fever which subsided with paracetamol in the preceding 2 days of hospital admission. Recent ECG performed 2 weeks prior to the incident was unremarkable (Normal sinus rhythm with heart rate of 88 beats/minute) He was not on any regular medications. Electrocardiogram performed after the procedure revealed paced rhythm He did well postoperatively and completely regained his cognitive function post pacemaker insertion. He displayed no further respiratory symptoms whilst his stay in the hospital with post procedure chest x-ray showing clear lung fields and a presence of the implanted pacemaker (Fig. 2). After ruling out all common causes we think that the development of complete heart block and him catching the SARS-CoV-2 virus cannot be a coincidence
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