ACC comments on Coronavirus and Cardiac Disease

Respiratory viruses associated with epidemics include influenza virus, severe acute respiratory syndrome (SARS), Middle East respiratory virus (MERS), H1N1 influenza, and now coronavirus 2019 (COVID-2019).

Cardiovascular complications of influenza include myocarditis, acute myocardial infarction, and exacerbation of heart failure (HF) — all contributing to increased mortality.

COVID-19 case reports suggest that there is increased myocardial injury (as evidenced by elevated high-sensitivity troponin I) , cardiac arrhythmias — most patients required ICU.

• Patients with HF and coronary artery disease are at increased risk of plaque rupture secondary to viral inflammation, so it is important to use plaque stabilizing agents such as statins.

• Procoagulant effects of inflammation can be ameliorated by antiplatelet therapy and anticoagulants.

• Angiotensin-converting enzyme 2 (ACE2) is expressed in the heart and SARS-CoV-2 virus binds to cells expressing receptors, particularly ACE2.

Ragavendra R. Baliga, MBBS, FACC
— Read on www.acc.org/latest-in-cardiology/ten-points-to-remember/2020/03/20/08/56/coronaviruses-and-the-cardiovascular