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Eur Cardiol . Cardiac Involvement Due to COVID-19: Insights from Imaging and Histopathology

tetano

Editor, Senior Moderator
Eur Cardiol


. 2023 Oct 18:18:e58.
doi: 10.15420/ecr.2023.02. eCollection 2023. Cardiac Involvement Due to COVID-19: Insights from Imaging and Histopathology

Valentina O Puntmann[SUP] 1 [/SUP], Anastasia Shchendrygina[SUP] 1 [/SUP], Carlos Rodriguez Bolanos[SUP] 1 [/SUP], Mame Madjiguène Ka[SUP] 1 [/SUP], Silvia Valbuena[SUP] 2 [/SUP], Andreas Rolf[SUP] 3 [/SUP], Felicitas Escher[SUP] 4 [/SUP], Eike Nagel[SUP] 1 [/SUP]



Affiliations
Abstract

Lingering cardiac symptoms are increasingly recognised complications of severe acute respiratory syndrome coronavirus 2 infection, now referred to as post-acute cardiovascular sequelae of COVID-19 (PASC). In the acute phase, cardiac injury is driven by cytokine release and stems from ischaemic and thrombotic complications, resulting in myocardial necrosis. Patients with pre-existing cardiac conditions are particularly vulnerable. Myocarditis due to a direct viral infection is rare. Chronic symptoms relate to either worsening of pre-existing heart disease (PASC - cardiovascular disease) or delayed chronic inflammatory condition due to heterogenous immune dysregulation (PASC - cardiovascular syndrome), the latter affecting a broad segment of previously well people. Both PASC presentations are associated with increased cardiovascular risk, long-term disability and reduced quality of life. The recognition and management of PASC in clinical settings remains a considerable challenge. Sensitive diagnostic methods are needed to detect subtler inflammatory changes that underlie the persistent symptoms in PASC - cardiovascular syndrome, alongside considerable clinical experience in inflammatory cardiac conditions.

Keywords: COVID-19; PASC; cardiovascular magnetic resonance; myocardial injury; myocarditis; post-acute sequelae of COVID-19.

 
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