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Abstract
RÉSUMÉ
Les atteintes cardiaques liées à l’infection à sars cov2 sont variées et fréquentes. Nous rapportons le cas d’un patient de 67 ans admis pour toux productive fébrile et syndrome de condensation pulmonaire basithoracique bilatéral avec examen cardiovasculaire normal. La PCR–covid 19 était positive et la tomodensitométrie thoracique était en faveur d’une pneumonie sévère à Sars cov-2. Un traitement à base d’antibiotiques et corticoïde a été administré dès l’entrée. Au troisième jour d’hospitalisation, on a noté l’installation de vertiges, associées à une bradycardie sévère. L’ECG de repos a révélé un bloc sino-atrial de 3ème degré, confirmé au Holter ECG. Son traitement a été poursuivi et on a noté un retour spontané en rythme sinusal avec amendement de la symptomatologie clinique. Ce cas nous rappelle l’importance de rechercher précocement et systématiquement des complications cardiaques durant l’infection à Sars cov- 2 qui pourraient aggraver le pronostic vital.
ABSTRACT
Cardiac disorders related to Sars cov-2 infection is varied and common. We report the case of a 67-year-old patient admitted with a febrile productive cough and bilateral basithoracic pulmonary condensation syndrome with normal cardiovascular examination. CRP-covid 19 was positive and chest CT scan was in favor of severe Sars cov-2 pneumonia. Antibiotics and corticosteroids were administered on admission. On the 3rd day of hospitalization, dizziness associated with severe bradycardia developed. Resting ECG revealed a 3rd degree sino-atrial block, confirmed on Holter ECG. His treatment was continued and there was a spontaneous return to sinus rhythm with improvement of the clinical symptomatology. This case reminds us of the importance of an early and systematic research for cardiac complications during Sars cov- 2 infection that could worsen the vital prognosis.
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References
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References
COVID Live - Coronavirus Statistics - Worldometer [Internet]. [cité 11 févr 2022]. Disponible sur: https://www.worldometers.info/coronavirus/
Azer SA. COVID-19: pathophysiology, diagnosis, complications and investigational therapeutics. New Microbes New Infect. 5 août 2020;37:100738.
Jabbour F, Kanmanthareddy A. Sinus Node Dysfunction. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cité 11 févr 2022]. Disponible sur: http://www.ncbi.nlm.nih.gov/books/NBK544253/
Cureus | Multiple Sinus Pauses in a Patient With COVID-19 [Internet]. [cité 11 févr 2022]. Disponible sur: https://www.cureus.com/articles/53904-multiple-sinus-pauses-in-a-patient-with-covid-19
Cimino G, Pascariello G, Bernardi N, Calvi E, Arabia G, Salghetti F, et al. Sinus Node Dysfunction in a Young Patient With COVID-19. JACC: Case Reports. 15 juill 2020;2(9):1240‑4.
Elices-Teja J, Bueno-Sacristán Á, Durán-Bobin O, Ferreiro-González AM, Gonzalez-Juanatey C. Sinus Node Syndrome in a critical COVID-19 patient. Rev Port Cardiol. 1 déc 2021;40(12):987‑8.
Babapoor-Farrokhran S, Batnyam U, Wiener PC, Kanjanahattakij N, Khraisha O, Amanullah A, et al. Atrioventricular and Sinus Node Dysfunction in Stable COVID-19 Patients. Sn Comprehensive Clinical Medicine. 2020;2(11):1955.
Babapoor-Farrokhran S, Rasekhi RT, Gill D, Babapoor S, Amanullah A. Arrhythmia in COVID-19. SN Compr Clin Med. 2020;2(9):1430‑5.
Yu C-M, Wong RS-M, Wu EB, Kong S-L, Wong J, Yip GW-K, et al. Cardiovascular complications of severe acute respiratory syndrome. Postgrad Med J. févr 2006;82(964):140‑4.
Bradyarrhythmias in patients with COVID-19: Marker of poor prognosis? - PubMed [Internet]. [cité 12 févr 2022]. Disponible sur: https://pubmed.ncbi.nlm.nih.gov/32820823/
Sick sinus syndrome - Diagnosis and treatment - Mayo Clinic [Internet]. [cité 11 févr 2022]. Disponible sur: https://www.mayoclinic.org/diseases-conditions/sick-sinus-syndrome/diagnosis-treatment/drc-20377560