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Reliable, easy-to-read patient information on common medical conditions β€” written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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COVID-19 associated cardiac arrest differential diagnosis

Introduction

Overview

Overview

COVID-19 associated inheritted cardiac arrest must be differentiated from other causes of cardiac arrest.

Differentiating inherited cardiac arrest from other causes of cardiac arrest

Differentiating inherited cardiac arrest from other causes of cardiac arrest

Inherited causes of cardiac arrest and malignant arrhythmia associated COVID-19 long QT syndrome Brugada syndrome Short QT syndrome Cathecolaminergic polymorphic ventricular tachaycardia
Gene mutation
  • loss of function in SCN5A in %30 of patients
EKG finding
  • QTc>450ms in men
  • QTc>470ms in women
  • Coved-type ST-segment elevation
  • T-wave inversion

in lead V1 and/or V2

Specific considerations in COVID19 patients
  • Controlling the fever for prevention of QT prolongation
  • Avoidance of usingβ‰₯ one drugs inducing QT prolongation
  • Controlling the fever as the main cause of cardiac arrest in brugada syndrome, especially in children less than 5 year old
  • Avoidance of administration of epinephrine, isoproterenol, and dobutamine, all Ξ± and/or B1 receptor agonists inducing ventricular arrhythmia
  • Controlling the stress related to COVID-19
  • Safety of flecainide without any interaction with lopinavir, ritonavir, and chloroquine.
fatal arrhythmia Ventricular fibrillation
  • QT, QTc is measured in milliseconds.
  • RR is measured in seconds and is the interval from the onset of one QRS complex to the onset of the next QRS complex.
References

References

  1. ↑ Antzelevitch C, Yan GX, Ackerman MJ, Borggrefe M, Corrado D, Guo J, Gussak I, Hasdemir C, Horie M, Huikuri H, Ma C, Morita H, Nam GB, Sacher F, Shimizu W, Viskin S, Wilde AA (October 2016). “J-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledge”. Heart Rhythm. 13 (10): e295–324. doi:10.1016/j.hrthm.2016.05.024. PMCΒ 5035208. PMIDΒ 27423412.
  2. ↑ van der Werf C, Wilde AA (April 2013). “Catecholaminergic polymorphic ventricular tachycardia: from bench to bedside”. Heart. 99 (7): 497–504. doi:10.1136/heartjnl-2012-302033. PMIDΒ 23390049.
  3. ↑ van Noord C, Eijgelsheim M, Stricker BH (July 2010). “Drug- and non-drug-associated QT interval prolongation”. Br J Clin Pharmacol. 70 (1): 16–23. doi:10.1111/j.1365-2125.2010.03660.x. PMCΒ 2909803. PMIDΒ 20642543.
  4. ↑ Priori, Silvia G.; Wilde, Arthur A.; Horie, Minoru; Cho, Yongkeun; Behr, Elijah R.; Berul, Charles; Blom, Nico; Brugada, Josep; Chiang, Chern-En; Huikuri, Heikki; Kannankeril, Prince; Krahn, Andrew; Leenhardt, Antoine; Moss, Arthur; Schwartz, Peter J.; Shimizu, Wataru; Tomaselli, Gordon; Tracy, Cynthia (2013). “HRS/EHRA/APHRS Expert Consensus Statement on the Diagnosis and Management of Patients with Inherited Primary Arrhythmia Syndromes”. Heart Rhythm. 10 (12): 1932–1963. doi:10.1016/j.hrthm.2013.05.014. ISSNΒ 1547-5271.
  5. ↑ White NJ (August 2007). “Cardiotoxicity of antimalarial drugs”. Lancet Infect Dis. 7 (8): 549–58. doi:10.1016/S1473-3099(07)70187-1. PMIDΒ 17646028.
  6. ↑ Amin AS, Herfst LJ, Delisle BP, Klemens CA, Rook MB, Bezzina CR, Underkofler HA, Holzem KM, Ruijter JM, Tan HL, January CT, Wilde AA (July 2008). “Fever-induced QTc prolongation and ventricular arrhythmias in individuals with type 2 congenital long QT syndrome”. J. Clin. Invest. 118 (7): 2552–61. doi:10.1172/JCI35337. PMCΒ 2423868. PMIDΒ 18551196.
  7. ↑ Amin AS, Meregalli PG, Bardai A, Wilde AA, Tan HL (August 2008). “Fever increases the risk for cardiac arrest in the Brugada syndrome”. Ann. Intern. Med. 149 (3): 216–8. doi:10.7326/0003-4819-149-3-200808050-00020. PMIDΒ 18678856.
  8. ↑ Michowitz Y, Milman A, Sarquella-Brugada G, Andorin A, Champagne J, Postema PG, Casado-Arroyo R, Leshem E, Juang J, Giustetto C, Tfelt-Hansen J, Wijeyeratne YD, Veltmann C, Corrado D, Kim SH, Delise P, Maeda S, Gourraud JB, Sacher F, Mabo P, Takahashi Y, Kamakura T, Aiba T, Conte G, Hochstadt A, Mizusawa Y, Rahkovich M, Arbelo E, Huang Z, Denjoy I, Napolitano C, Brugada R, Calo L, Priori SG, Takagi M, Behr ER, Gaita F, Yan GX, Brugada J, Leenhardt A, Wilde A, Brugada P, Kusano KF, Hirao K, Nam GB, Probst V, Belhassen B (September 2018). “Fever-related arrhythmic events in the multicenter Survey on Arrhythmic Events in Brugada Syndrome”. Heart Rhythm. 15 (9): 1394–1401. doi:10.1016/j.hrthm.2018.04.007. PMIDΒ 29649615. Vancouver style error: initials (help)
  9. ↑ Luo C, Wang K, Liu T, Zhang H (July 2018). “Computational Analysis of the Action of Chloroquine on Short QT Syndrome Variant 1 and Variant 3 in Human Ventricles”. Conf Proc IEEE Eng Med Biol Soc. 2018: 5462–5465. doi:10.1109/EMBC.2018.8513572. PMIDΒ 30441573.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Zand, M.D.