Cardiovascular Considerations for the Internist and Hospitalist in the COVID-19 Era
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.
Cardiologists should be prepared to assist other specialties in managing these cardiac complications and protocols for triaging, diagnosing, and managing patients with COVID-19 with cardiovascular complications should be refined as data become available. Caution should be exercised because classical myocardial infarction symptoms may be obscured leading to underdiagnosis of cardiac injury or overdiagnosis and inappropriate diagnostic testing or imaging during shortages in personal protective equipment and staffing.
This review provides recommendations for a systematic approach to the cardiovascular evaluation of patients with COVID-19 for the internist or hospitalist. Pressing cardiovascular queries related to COVID-19 faced by frontline physicians, from baseline cardiac evaluation needed, to appropriate cardiac imaging, and timing of cardiology input, are addressed.
To read the entire article in the American Journal of Medicine, click here: https://www.amjmed.com/article/S0002-9343(20)30550-7/fulltext