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Review
. 2020 Jul;50(7):543-554.
doi: 10.4070/kcj.2020.0205.

Updates of Cardiovascular Manifestations in COVID-19: Korean Experience to Broaden Worldwide Perspectives

In Cheol Kim  1 , Hyun Ah Kim  2 , Jae Seok Park  3 , Chang Wook Nam  4
Affiliations
Review

Updates of Cardiovascular Manifestations in COVID-19: Korean Experience to Broaden Worldwide Perspectives

In Cheol Kim et al. Korean Circ J. 2020 Jul.

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. Not just respiratory complications such as pneumonia and acute respiratory distress syndrome, cardiac manifestations have drawn attention due to the increased risk of mortality and morbidity related to SARS-CoV-2 infections. The mechanisms of the cardiac injury related to SARS-CoV-2 infections have been direct cardiac injury caused by angiotensin converting enzyme 2, hypoxemia, microvascular damage, and a systemic inflammatory response. Stress induced cardiomyopathy in a critically ill condition and acute coronary syndrome due to a vulnerable plaque rupture with coagulopathy can finally lead to acute heart failure with further cardiac manifestations. When dealing with the highly contagious viral disease-related cardiac manifestations, we should carefully apply the diagnostic and therapeutic methods to achieve the best therapeutic results without adding any risk of disease transmission.

Keywords: COVID-19; Cardiac injury; Cardiac manifestation; Coronavirus; Heart; SARS-CoV-2.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Figure 1
Figure 1. The trend of COVID-19 confirmed patients in South Korea until May 31, 2020. The total numbers in Korea are depicted in the blue line and numbers in Daegu/North Gyeongsang province are depicted in the red line.
COVID-19 = coronavirus disease 2019.
Figure 2
Figure 2. Evaluation for the cardiac manifestation in COVID-19 and diagnostic algorithm of COVID-19 associated cardiac injury.
COVID-19 = coronavirus disease 2019; CT = computed tomography; URL = upper reference limit.
Figure 3
Figure 3. Mechanism of myocarditis and acute cardiac injury by SARS-CoV-2 leading to acute heart failure.
SARS-CoV-2 = severe acute respiratory syndrome-coronavirus 2; ACE = angiotensin converting enzyme; CMP = cardiomyopathy.
See this image and copyright information in PMC

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