1. Post-Acute COVID-19 Syndrome and the cardiovascular system: What is known?
- Author
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Jeffrey J. Hsu, Neal M. Dixit, Austin Churchill, and Ali Nsair
- Subjects
SARS-COV-1, Severe Acute Respiratory Syndrome Coronavirus-1 ,medicine.medical_specialty ,POTS, Post-Acute COVID-19 Syndrome ,Long COVID ,Myocarditis ,CBT, cognitive behavioral therapy ,MERS, Middle East Respiratory Syndrome ,Cardiology ,Autopsy ,Review Article ,Chest pain ,Coronavirus Disease 2019 ,Coronary artery disease ,ECG, electrocardiography ,Pericarditis ,T1MI, type 1 myocardial infarction ,Internal medicine ,Postural Orthostatic Tachycardia Syndrome ,ACE2, angiotensin converting enzyme-2 ,MCAS, Mast Cell Activation Syndrome ,medicine ,Palpitations ,TTT, tilt table testing ,T2MI, type 2 myocardial infarction ,LGE, late gadolinium enhancement ,SARS-CoV-2 ,business.industry ,CV, cardiovascular ,ECV, extracellular volume ,General Medicine ,medicine.disease ,CMR, cardiac magnetic resonance imaging ,CFS, Chronic Fatigue Syndrome ,Long-Haul COVID ,CRP, C-reactive protein ,Biomarker (medicine) ,AF/AFL, atrial fibrillation or flutter ,medicine.symptom ,business - Abstract
Post-Acute COVID-19 Syndrome (PACS) is defined by persistent symptoms >3–4 weeks after onset of COVID-19. The mechanism of these persistent symptoms is distinct from acute COVID-19 although not completely understood despite the high incidence of PACS. Cardiovascular symptoms such as chest pain and palpitations commonly occur in PACS, but the underlying cause of symptoms is infrequently known. While autopsy studies have shown that the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) rarely causes direct myocardial injury, several syndromes such as myocarditis, pericarditis, and Postural Orthostatic Tachycardia Syndrome have been implicated in PACS. Additionally, patients hospitalized with acute COVID-19 who display biomarker evidence of myocardial injury may have underlying coronary artery disease revealed by the physiological stress of SARS-CoV-2 infection and may benefit from medical optimization. We review what is known about PACS and the cardiovascular system and propose a framework for evaluation and management of related symptoms.
- Published
- 2021
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