Abstract
The article is devoted to the analysis of cardiovascular lesions in COVID-19. The main problems of comorbidity are described and recommendations for the treatment of patients with myocardial infarction and COVID-19 are generalized, the features of the appointment of certain groups of drugs are emphasized.The aim of the research. To study the effect of coronavirus on the cardiovascular system to understand the correct algorithm for providing medical care for cardiovascular diseases.Methods. As a methodological basis, the article uses the existing data about the epidemiological characteristics of coronavirus infections SARS, MERS, COVID-19 and damage of the cardiovascular system in existing heart diseases and viral pathologies. A new cardiac lesion in the form of acute heart injury is also described, confirmed by an increase in troponin.Results. As a result of the high contagiousness of the COVID-19 viral infection, treatment of patients with acute myocardial infarction or other cardiovascular pathology in patients with undetermined SARS COV-2 status, it is performed as if he is positive, according to current guidelines. It is advisable for all patients to evaluate the systolic function of the left ventricle during angiography in order to reduce the need for echocardiography and decline the risk of staff infection. Combination of hydroxychloroquine and azithromycin has the proarrhythmogenic effect.Conclusions. In the context of a global pandemic of coronavirus infection, existing data on the possible risks and lesions of the cardiovascular system in patients with COVID-19 should be taken into account. The treatment and prevention of the spread of infection is based on the assumption that all patients can be potentially infected. It is advisable to use thromboprophylaxis in patients with COVID-19, especially those who have activation of the coagulation system. Treatment of severe COVID-19-pneumonia also requires the appointment of anticoagulants. The key point is the interdisciplinary management of severe cases of COVID-19
Highlights
Сердечно-сосудистые осложнения гриппа, включая миокардит, острый инфаркт миокарда и обострение сердечной недостаточности (СН), были хорошо известны во время предыдущих исторических эпидемий и вносят значительный вклад в смертность [3]
В то же время Американская ассоциация сердца, Американский колледж кардиологов рекомендуют с осторожностью назначать гидроксихлорохин и азитромицин при COVID-19 у пациентов с сердечно-сосудистыми заболеваниями, так как оба препарата могут вызывать torsade de pointes и увеличивать риск других аритмий и внезапной смерти
Summary
Сердечно-сосудистые осложнения гриппа, включая миокардит, острый инфаркт миокарда и обострение сердечной недостаточности (СН), были хорошо известны во время предыдущих исторических эпидемий и вносят значительный вклад в смертность [3]. В ранних сообщениях высказанные предположения, что пациенты с сопутствующими заболеваниями подвержены более высокому риску осложнений или смертности – до 50 % госпитализированных пациентов имеют хронические заболевания (40 % – сердечно-сосудистые или цереброваскулярные заболевания).
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