Takotsubo syndrome and covid-19: a case report

COVID-19 is an emerging disease, first identified in Wuhan, China and which acquired pandemic status in early 2020 according to WHO. Clinically, it presents with cough, fever, odynophagia, runny nose, prostration, abdominal pain and progressive dyspnea. However, far from causing only a disease of the respiratory system, infection by the virus causes widespread inflammation, which can cause severe complications, demonstrating varying levels of severity for those affected by this pathology. Among the most important complications, those associated with the respiratory and cardiovascular system stand out, such as severe pneumonia with pulmonary fibrosis, endocarditis, heart failure, venous and arterial thromboembolism and pulmonary hypertension with pulmonary edema. Takotsubo Syndrome (TS), also known as broken heart syndrome, is characterized by acute left ventricular failure, with dysfunction of the leftventricle wall whose causes can be idiopathic, due to physical or emotional stress. The aim of this study was to report the occurrence of TS in a patient admitted to an intensive care unit in a city in the interior of the state of São Paulo (SP), diagnosed with COVID-19 by RT-PCR. The methodology consisted of reviewing the patient’s medical record, as well as diagnostic tests performed during hospitalization, associating a study of the literature on the two pathologies. Case report. A 75-year-old female patient, complaining of cough, fever of 38 °C and progressive dyspnea, was admitted to the emergency room and admitted to the ICU, with a positive RT-PCR COVID-19 test, progressing to sustained ventricular tachycardia. After reversing the tachyarrhythmia, she showed signs of acute myocardial infarction with ST-segment elevation (AMI with STSE) , but on echocardiogram, medium-apical hypokinesia of all walls and an ejection fraction (EF) of 32%. Emergency cineangio corona riography did not show significant obstructive lesions and ventriculography showing apical swelling. Early recognition of TS is essential for the accurate management of complications and for reducing morbidity and mortality in patients with cardiovascular repercussions in the presence of viral infections, such as COVID-19.