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Bacharaki D, Giannakopoulos P, Markakis K, Papas C, Theodorou A, Zoi V, Tsivgoulis G, Lionaki S. COVID-19 presenting with persistent hiccup and myocardial infarction in a peritoneal dialysis patient: A case report. World J Virol 2022; 11:198-203. [PMID: 36159613 PMCID: PMC9372788 DOI: 10.5501/wjv.v11.i4.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/01/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Persistent hiccups, lasting more than 48 h, have been described as an atypical presentation of coronavirus disease 19 (COVID-19) in the general population. To the best of our knowledge, this is the first report of persistent hiccups and non-ST elevation myocardial injury (NSTEMI) as an atypical presentation of COVID-19 in a peritoneal dialysis (PD) patient.
CASE SUMMARY A 70-year old man, who had been on PD for 3 years with a history of ischemic heart failure and reduced ejection fraction, presented for a scheduled radionuclide myocardial scan. Upon arrival, he complained of anorexia, nausea for 5 d, and unremitting hiccups for the previous 48 h. Clinical and laboratory examinations revealed an NSTEMI plus a positive nasopharyngeal reverse transcriptase polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2. COVID-19 lung involvement was mild and was resolved without specific treatment. Myocardial injury was managed by coronary catheterization and stenting, while hiccups responded only to baclofen per os.
CONCLUSION Persistent hiccups and NSTEMI can be atypical presentations of COVID-19 in peritoneal dialysis patients, which may be due to involvement of the central nervous system and myocardial injuries.
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Affiliation(s)
- Dimitra Bacharaki
- Department of Nephrology, Attikon University Hospital, Chaidari 12462, Greece
| | | | - Konstantinos Markakis
- Department of Internal Medicine, Attikon University Hospital, Chaidari 12462, Greece
| | - Christos Papas
- Department of Cardiology, Attikon University Hospital, Chaidari 12462, Greece
| | - Aikaterini Theodorou
- Second Department of Neurology, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Vasiliki Zoi
- Department of Nephrology, Attikon University Hospital, Chaidari 12462, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Sophia Lionaki
- Department of Nephrology, Attikon University Hospital, Chaidari 12462, Greece
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Duca ȘT, Chetran A, Miftode RȘ, Mitu O, Costache AD, Nicolae A, Iliescu-Halițchi D, Halițchi-Iliescu CO, Mitu F, Costache II. Myocardial Ischemia in Patients with COVID-19 Infection: Between Pathophysiological Mechanisms and Electrocardiographic Findings. Life (Basel) 2022; 12:life12071015. [PMID: 35888103 PMCID: PMC9318430 DOI: 10.3390/life12071015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 12/29/2022] Open
Abstract
Given the possible pathophysiological links between myocardial ischemia and SARS-CoV-2 infection, several studies have focused attention on acute coronary syndromes in order to improve patients’ morbidity and mortality. Understanding the pathophysiological aspects of myocardial ischemia in patients infected with SARS-CoV-2 can open a broad perspective on the proper management for each patient. The electrocardiogram (ECG) remains the easiest assessment of cardiac involvement in COVID-19 patients, due to its non-invasive profile, accessibility, low cost, and lack of radiation. The ECG changes provide insight into the patient’s prognosis, indicating either the worsening of an underlying cardiac illnesses or the acute direct injury by the virus. This indicates that the ECG is an important prognostic tool that can affect the outcome of COVID-19 patients, which important to correlate its aspects with the clinical characteristics and patient’s medical history. The ECG changes in myocardial ischemia include a broad spectrum in patients with COVID-19 with different cases reported of ST-segment elevation, ST-segment depression, and T wave inversion, which are associated with severe COVID-19 disease.
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Affiliation(s)
- Ștefania Teodora Duca
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700145 Iasi, Romania; (Ș.T.D.); (R.Ș.M.); (O.M.); (A.D.C.); (A.N.); (D.I.-H.); (F.M.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Adriana Chetran
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700145 Iasi, Romania; (Ș.T.D.); (R.Ș.M.); (O.M.); (A.D.C.); (A.N.); (D.I.-H.); (F.M.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
- Correspondence: ; Tel.: +40-741089910
| | - Radu Ștefan Miftode
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700145 Iasi, Romania; (Ș.T.D.); (R.Ș.M.); (O.M.); (A.D.C.); (A.N.); (D.I.-H.); (F.M.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Ovidiu Mitu
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700145 Iasi, Romania; (Ș.T.D.); (R.Ș.M.); (O.M.); (A.D.C.); (A.N.); (D.I.-H.); (F.M.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Alexandru Dan Costache
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700145 Iasi, Romania; (Ș.T.D.); (R.Ș.M.); (O.M.); (A.D.C.); (A.N.); (D.I.-H.); (F.M.); (I.I.C.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Ana Nicolae
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700145 Iasi, Romania; (Ș.T.D.); (R.Ș.M.); (O.M.); (A.D.C.); (A.N.); (D.I.-H.); (F.M.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Dan Iliescu-Halițchi
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700145 Iasi, Romania; (Ș.T.D.); (R.Ș.M.); (O.M.); (A.D.C.); (A.N.); (D.I.-H.); (F.M.); (I.I.C.)
- Department of Cardiology, Arcadia Hospital, 700620 Iasi, Romania
| | - Codruța-Olimpiada Halițchi-Iliescu
- Department of Mother and Child Medicine-Pediatrics, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
- Department of Pedriatics, Arcadia Hospital, 700620 Iasi, Romania
| | - Florin Mitu
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700145 Iasi, Romania; (Ș.T.D.); (R.Ș.M.); (O.M.); (A.D.C.); (A.N.); (D.I.-H.); (F.M.); (I.I.C.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Irina Iuliana Costache
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700145 Iasi, Romania; (Ș.T.D.); (R.Ș.M.); (O.M.); (A.D.C.); (A.N.); (D.I.-H.); (F.M.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
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