It is clear that existing cardiovascular disease is a major risk factor for COVID-19 and related adverse outcomes. In addition to acute respiratory syndrome, a large cohort also develop myocardial or vascular dysfunction, in part from inflammation and renin angiotensin system activation with increased sympathetic outflow, cardiac arrhythmias, ischemia, heart failure, and thromboembolic complications that portend poor outcomes related to COVID-19.
We summarize recent information for hospitalists and internists on the front line of this pandemic regarding its cardiovascular impacts and management and the need for cardiovascular consultation.
The COVID-19 pandemic focuses on respiratory manifestations, but evidence has emerged relative to major cardiovascular implications. Preexisting cardiovascular conditions increase risk for COVID-19 and also for cardiovascular manifestations sometimes leading to death. Understanding this aspect is imperative for the internal medicine community.
Cardiovascular manifestations range from arrhythmias to acute cardiomyopathies, myocarditis, thromboembolic disorders, and shock. Conversely in presentations appearing to be cardiovascular, COVID-19 infection should also be considered. Given the extent and variability of cardiovascular manifestations, care of these patients is challenging and includes direct virus effects and possible iatrogenic effects from treatments.
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-Michael R. Massoomi, MD, R. David Anderson, MD, Mustafa M. Ahmed, MD, Osama Dasa, MD, Philip George Jr., MD, William M. Miles, MD, Juan M. Aranda Jr., MD, Carl J. Pepine, MD
