Transient ST Segment Elevation in a Patient with COVID-19 and a Normal Transthoracic Echocardiogram

• Published in: European journal of case reports in internal medicine Vol. 7; no. 10; p. 001913
• Main Authors: Tuaima, Tareq, Kinsara, Abdulhalim J, Alrajawi, Amtalkhaliq, Allam, Hassan H, Alfakih, Shadwan
• Format: Journal Article
• Language: English
• Published: Italy SMC Media Srl 07.09.2020; SMC MEDIA SRL
• Subjects: covid-19; echocardiogram; st segment elevation; COVID-19; ST segment elevation; echocardiogram
• ISSN: 2284-2594; 2284-2594
• DOI: 10.12890/2020_001913

The effect of COVID-19 on the cardiovascular system still needs to be clarified. Patients can develop a spectrum of cardiac diseases, from mild myocarditis to acute coronary syndrome with an impaired systolic fraction. We describe an interesting case of transient ST segment elevation in a COVID-19 patient admitted to ICU for severe respiratory distress syndrome. During his stay in ICU, the patient developed transient ST segment elevation in inferior-lateral leads which promptly resolved without requiring any additional invasive and/or pharmacological treatment. Transthoracic echocardiography showed a preserved ejection fraction without any regional abnormalities and the rise in enzyme biomarkers was insignificant. The case highlights the importance of avoiding invasive procedures in this subset of patients to reduce both patient complications and medical staff exposure. Careful evaluation including echocardiogram and second-line examinations should be performed before invasive and aggressive treatment is undertaken. Transient ST elevation may occur in critically ill COVID-19 patients.Early recognition is important to avoid unnecessary intervention or thrombolytic therapy.