Thread by @serioustaurean, Cardiology thread:In heart pts, flu can cause heart attacks/worsen heart failure/predispose to [...]

Cardiology thread:
In heart pts, flu can cause heart attacks/worsen heart failure/predispose to pneumonia. #COVID19 may be no different. Heart pts are more likely to have severe Covid infection than others, esp elderly/post-transplant/cardiomyopathy pts https://www.nature.com/articles/s41569-020-0360-5
1/">https://www.nature.com/articles/...

COVID-19 and the cardiovascular system

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells through ACE2 receptors, leading to coronavirus disease (COVID-19)-related pneumonia, while also causing acute myocard...

https://www.nature.com/articles/s41569-020-0360-5

#COVID19 can PRESENT as cardiac issue: STEMI with near/normal coronaries, Cardiogenic shock needing circulatory support, heart failure/sev LV dysf (?myocarditis), Atrial fibrillation, decompensation of prior CHF, arrhythmias due to HCQS/azithro etc https://www.medpagetoday.com/infectiousdisease/covid19/85520

2/">https://www.medpagetoday.com/infectiou...

Chinese Doctors Share the Playbook for Severe COVID-19

Tips from Chinese doctors on the front lines

https://www.medpagetoday.com/infectiousdisease/covid19/85520

Heart disease/diabetes/HT pts have higher mortality with Covid. These factors are clustered in elderly. Whether

https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬆️" title="Upwards arrow" aria-label="Emoji: Upwards arrow">mortality is due to old age or comorbidities is not resolved. Data suggests

https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬆️" title="Upwards arrow" aria-label="Emoji: Upwards arrow"> mortality in Covid pts with myocardial injury by Trop/ECG

https://jamanetwork.com/journals/jamacardiology/fullarticle/2763844?resultClick=1

3/">https://jamanetwork.com/journals/...

Association of Coronavirus Disease 2019 (COVID-19) With Myocardial Injury and Mortality

Coronavirus disease 2019 (COVID-19) has emerged as a pandemic and a public health crisis of global proportions. As a medical community, we are actively engaged in a real-time data gathering mode to...

https://jamanetwork.com/journals/jamacardiology/fullarticle/2763844?resultClick=1

Principles in cardiac emergency:

1. Transmission control & HCW protection is top concern
2. Assess for both Covid & cardiac problems & treat both concomitantly
3. Interventions to be deferred unless life-threatening

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.047011

4/">https://www.ahajournals.org/doi/10.11...

During Covid pandemic no routine hospital visits for cardiac/diabetic/HTN. Video consults (WhatsApp/FaceTime even if no dedicated software) encouraged. All routine interventions incl CTOs/structural heart to be deferred unless life-saving

Tips: https://youtu.be/W5zsEpka2HE

5/">https://youtu.be/W5zsEpka2...

Recent controversy on ACEI/ARB use in hypertensives during Covid pandemic has backers for both harms & benefits. But, evidence for harm are so tenuous that most experts/societies advice continuation of these drugs unless new data emerges
https://www.youtube.com/watch?v=5b9hJ81YxZo

6/">https://www.youtube.com/watch...

Pt presenting with breathlessness, NSTEMI & STEMI to be managed as if Covid+ unless otherwise proven by test. HCWs to wear appropriate protective gear (including PPE for urgent interventions). Nebulisation/NIV to be avoided. If sats <90% intubate/ventilate rather than wait

7/ https://twitter.com/kambismashayek1/status/1245974819545456640">https://twitter.com/kambismas...

https://twitter.com/kambismashayek1/status/1245974819545456640

NSTEMI: manage conservatively unless hemodynamic instability or severe ongoing ischemia. Risk assessment & intervention to be electively done later. In pts with primarily non-cardiac presentations, avoid measuring Troponin: Type 2 NSTEMI should stay out of the lab at any cost

8/

Routine follow-up echoes to be avoided. If echo is imperative, echocardiographer shud don PPE & preferably perform study from left side of the pt to minimise contact.

Non-essential TEE should be totally avoided during Covid pandemic: https://www.asecho.org/wp-content/uploads/2020/04/COPE_COVID_Supplement_FINAL.pdf

Other">https://www.asecho.org/wp-conten... imaging:

9/ https://twitter.com/geraldmaurer/status/1246481275352989696">https://twitter.com/geraldmau...

Off-label use of Hydroxychloroquine for prevention or treatment of Covid is not based on robust evidence. Potential toxicity of HCQS & chloroquine should be discussed with pt if prescribed or if demanded by patient

https://amp.scroll.in/pulse/957938/death-of-assam-doctor-raises-questions-about-malaria-drug-recommended-for-covid-19-health-workers

10/">https://amp.scroll.in/pulse/957...

Death of Assam doctor raises questions about malaria drug recommended for Covid-19 health workers

Many Indian medical workers are consuming the drug, despite lack of solid evidence about its efficacy.

https://amp.scroll.in/pulse/957938/death-of-assam-doctor-raises-questions-about-malaria-drug-recommended-for-covid-19-health-workers

Cardiac arrest in suspected Covid infection:

11/11 https://twitter.com/circaha/status/1248250318158090244">https://twitter.com/circaha/s...

https://twitter.com/circaha/status/1248250318158090244

Latest Threads Unrolled: