Open Access

Novel coronavirus 19 (COVID-19) associated sinus node dysfunction: a case series

logo

Date: 8 May 2020
Journal: European Heart Journal - Case Reports , Volume 4 , Issue FI1 , Pages 1 - 6
Authors: G. Peigh , M. Leya , J. Baman , E. Cantey , B. Knight , J. Flaherty , C. Camm , G. Cinier , R. Ang , C. Camm , R. Thomson

ESC Journals

AbstractBackground

Novel coronavirus-19 disease (COVID-19) is associated with significant cardiovascular morbidity and mortality. To date, there have not been reports of sinus node dysfunction (SND) associated with COVID-19. This case series describes clinical characteristics, potential mechanisms, and short-term outcomes of COVID-19 patients who experience de novo SND.

Case summary

We present two cases of new-onset SND in patients recently diagnosed with COVID-19. Patient 1 is a 70-year-old female with no major past medical history who was intubated for acute hypoxic respiratory failure secondary to COVID-19 pneumonia and developed new-onset sinus bradycardia without a compensatory increase in heart rate in response to relative hypotension. Patient 2 is an 81-year-old male with a past medical history of an ascending aortic aneurysm, hypertension, and obstructive sleep apnoea who required intubation for COVID-19-induced acute hypoxic respiratory failure and exhibited new-onset sinus bradycardia followed by numerous episodes of haemodynamically significant accelerated idioventricular rhythm. Two weeks following the onset of SND, both patients remain in sinus bradycardia.

Discussion

COVID-19-associated SND has not previously been described. The potential mechanisms for SND in patients with COVID-19 include myocardial inflammation or direct viral infiltration. Patients diagnosed with COVID-19 should be monitored closely for the development of bradyarrhythmia and haemodynamic instability.

About the contributors

Graham Peigh

Role: Author

Marysa V Leya

Role: Author

Jayson R Baman

Role: Author