Evaluation of the causes of chest pain and its relationship with the cardiovascular system in COVID-19 patients

Abstract

Aim: Chest pain is one of the most common complaints of patients in the emergency departments during the pandemic and non-pandemic period. Because the cause of chest pain can range, from an ordinary, harmless muscle pull to serious cardiac complication ultimately leading to cardiac arrest. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells through angiotensin converting enzyme 2 receptors, leading to coronavirus disease (COVID-19)-related pneumonia, and also causing acute cardiac injury and chronic damage to the cardiovascular system. COVID-19 contributes to the development of serious cardiovascular complications such as acute coronary syndrome, myocarditis, stress-cardiomyopathy, arrhythmias, cardiogenic shock, and cardiac arrest. In this study, it was aimed to determine the effects of COVID-19 on the cardiovascular system by evaluating the causes of chest pain in COVID-19 patients who applied to the emergency department with chest pain. Methods: This retrospective study was conducted by examining the files of COVID-19 patients who applied to a district emergency department with chest pain. Results: The files of 102 COVID-19 patients were reviewed. The most common causes of CP were musculoskeletal system (39.2%), respiratory system (23.5%), CVS diseases (20.6%), idiopathic causes (8.8%), gastrointestinal system diseases (7%, 9). Cardiac causes are non ST-segment elevation myocardial infarction (NSTMI), arrhythmia, ST-segment elevation myocardial infarction (STEMI) and unstable angina pectoris (USAP), respectively. Troponin value was higher in patients with cardiac chest pain (p=0.02), and ferritin value was higher in patients with pneumonia (p=0.01). Conclusions: Chest pain or chest tightness is common in patients with active COVID-19. Although the causes of chest pain are due to musculoskeletal pathologies, both COVID-19 and cardiac origin chest pains due to direct cardiovascular system pathologies should be kept in mind.