Abstract
The novel coronavirus disease 2019 (COVID-19) is associated with several cardiovascular manifestations including myocardial injury, myocarditis, arrhythmia, and pulmonary embolism. Rare cases of stress-induced cardiomyopathy, or takotsubo syndrome have also been reported during the acute infection, and secondary to stress following lockdown and self-isolation. Diagnosis in the setting of the acute infection is challenging since conventional imaging modalities such as transthoracic echocardiography and coronary angiography should be restricted to minimize physician-patient contact until the patients is tested negative for COVID-19. The use of point of care hand-held ultrasound is appropriate for this purpose. The overall course of the disease seems to be similar to takotsubo in the general population. Physicians should be familiar with the clinical presentation, possible complications, and management of takotsubo during COVID-19 outbreak. Here, we review the special considerations in the diagnosis and management of takotsubo syndrome during the current pandemic.
Highlights
The novel coronavirus disease 2019 (COVID-19) is associated with several cardiovascular manifestations including myocardial injury, myocarditis, arrhythmia, and pulmonary embolism
We review the special considerations for the diagnosis and management of Takotsubo syndrome (TTS) and the possible impact of the overwhelming stress accompanying its incidence during the current pandemic
In stable patients with preserved global left ventricular function and high suspicion for TTS according to clinical course, ECG, and echocardiography, exclusion of obstructive coronary artery disease using cardiac computed tomography is recommended in order to reduce the risk of contamination
Summary
The novel coronavirus disease 2019 (COVID-19) constitutes an ongoing medical challenge through involvement of multiple organs. The disease is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and it was first identified in December. Takotsubo syndrome (TTS) is one of the rare cardiovascular manifestations that has been reported in COVID-19 [9]. Clinical presentation often mimics acute coronary syndrome (ACS) with chest pain, ECG and echocardiographic changes, and elevated cardiac biomarkers [12,13]. Key criteria for diagnosis include typical echocardiographic appearance of basal hypercontractility and apical ballooning, and patent coronary arteries without obstructive disease during angiography [14]. We review the special considerations for the diagnosis and management of TTS and the possible impact of the overwhelming stress accompanying its incidence during the current pandemic.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
