Background Cardiovascular complications of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV2) are known to be associated with poor outcome. A small number of case series and reports have described cases of myocarditis and ischaemic events, however, knowledge on the aetiology of acute cardiac failure in SARS-CoV2 remains limited. We describe the occurrence and risk stratification imaging correlates of ‘takotsubo’ stress cardiomyopathy presenting in a patient with Coronavirus Disease 2019 (COVID-19) in the intensive care unit. Case summary An intubated 53-year old patient with COVID19 suffered acute haemodynamic collapse in the intensive care unit, and was thus investigated with transthoracic echocardiography (TTE), 12-lead electrocardiograms (ECG) and serial troponins and blood tests, and eventually coronary angiography due to clinical suspicion of ischaemic aetiology. Echocardiography revealed a reduced ejection fraction, with evident extensive apical akinesia spanning multiple coronary territories. Troponins and NT-proBNP were elevated, and ECG revealed ST elevation: coronary angiography was thus performed. This revealed no significant coronary stenosis. Repeat echocardiography performed within the following week revealed a substantial recovery of ejection fraction and wall motion abnormalities. Despite requirement of a prolonged ICU stay, the patient now remains clinically stable, and is on spontaneous breathing. Conclusion This case report presents a case of takotsubo stress cardiomyopathy occurring in a critically unwell patient with COVID19 in the intensive care setting. Stress cardiomyopathy may be an acute cardiovascular complication of COVID-19 infection. In the COVID19 critical care setting, urgent bedside echocardiography is an important tool for initial clinical assessment of patients suffering haemodynamic compromise. Supplementary Information The online version contains supplementary material available at 10.1186/s12947-021-00251-4.
【저자키워드】 COVID-19, coronavirus, Stress, Cardiomyopathy, Tako-tsubo, 【초록키워드】 SARS-CoV2, COVID19, Critical care, intensive care, knowledge, Infection, troponin, outcome, Case report, ICU, ECG, cardiovascular, risk stratification, echocardiography, myocarditis, Patient, Complication, NT-proBNP, acute respiratory distress, Repeat, cardiac failure, blood tests, Ejection fraction, Intubated, supplementary material, clinical suspicion, syndrome, Abnormalities, aetiology, complication of COVID-19, 12-lead electrocardiogram, initial, Occurrence, described, performed, the patient, investigated, clinically, elevated, events, reduced, case sery, suffered, presenting, TTE, 【제목키워드】 coronavirus disease, Emergency, Cardiac imaging,