Lal, Sean

Hayward, Christopher S

De Pasquale, Carmine

Kaye, David

Javorsky, George

Bergin, Peter

Atherton, John J

Ilton, Marcus K

Weintraub, Robert G

Nair, Priya

Rudas, Mate

Dembo, Lawrence

Doughty, Robert N

Kumarasinghe, Gayathri

Juergens, Craig

Bannon, Paul G

Bart, Nicole K

Chow, Clara K

Lattimore, Jo-Dee

Kritharides, Leonard

Totaro, Richard

Macdonald, Peter S

2020-05-01

Up to one-third of COVID-19 patients admitted to intensive care develop an acute cardiomyopathy, which may represent myocarditis or stress cardiomyopathy. Further, while mortality in older patients with COVID-19 appears related to multi-organ failure complicating acute respiratory distress syndrome (ARDS), the cause of death in younger patients may be related to acute heart failure. Cardiac involvement needs to be considered early on in critically ill COVID-19 patients, and even after the acute respiratory phase is passing. This Statement presents a screening algorithm to better identify COVID-19 patients at risk for severe heart failure and circulatory collapse, while balancing the need to protect health care workers and preserve personal protective equipment (PPE). The significance of serum troponin levels and the role of telemetry and targeted transthoracic echocardiography (TTE) in patient investigation and management are addressed, as are fundamental considerations in the management of acute heart failure in COVID-19 patients.

Royal Prince Alfred Hospital, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia. Electronic address: sean.lal@sydney.edu.au..

St Vincent's Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia. Electronic address: cshayward@stvincents.com.au..

Flinders Medical Centre and Flinders University, Adelaide, SA, Australia..

Alfred Hospital and the Baker Heart and Diabetes Institute, Melbourne, Vic, Australia..

The Prince Charles Hospital, Brisbane, Qld, Australia; The University of Queensland, Brisbane, Qld, Australia..

Alfred Hospital and the Baker Heart and Diabetes Institute, Melbourne, Vic, Australia..

The University of Queensland, Brisbane, Qld, Australia; Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia..

Royal Darwin Hospital, Darwin, NT, Australia..

Royal Children's Hospital and the University of Melbourne, Melbourne, Vic, Australia..

St Vincent's Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia..

Royal Prince Alfred Hospital, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia..

Fiona Stanley Hospital, Perth, WA, Australia..

Auckland District Health Board and University of Auckland, Auckland, New Zealand..

The University of New South Wales, Sydney, NSW, Australia; Liverpool Hospital, Sydney, NSW, Australia..

The University of New South Wales, Sydney, NSW, Australia; Liverpool Hospital, Sydney, NSW, Australia..

Royal Prince Alfred Hospital, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia..

St Vincent's Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia..

The University of Sydney, Sydney, NSW, Australia; Westmead Hospital, Sydney, NSW, Australia..

Royal Prince Alfred Hospital, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia..

The University of Sydney, Sydney, NSW, Australia; Concord Repatriation General Hospital, Sydney, NSW, Australia..

Royal Prince Alfred Hospital, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia..

St Vincent's Hospital, Sydney, NSW, Australia; The University of New South Wales, Sydney, NSW, Australia. Electronic address: peter.macdonald@svha.org.au..

Heart, lung & circulation 2020-05-01

https://pubmed.ncbi.nlm.nih.gov/32418875/?otool=iaurydwlib

https://hdl.handle.net/10137/8368

Acute cardiomyopathy

COVID-19

High sensitivity troponin

Myocarditis

Screening algorithm

Targeted transthoracic echocardiogram

COVID-19 and Acute Heart Failure: Screening the Critically Ill - A Position Statement of the Cardiac Society of Australia and New Zealand (CSANZ).

Letter

Publication