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Case Reports
. 2020 Jun;36(6):966.e1-966.e4.
doi: 10.1016/j.cjca.2020.03.028. Epub 2020 Mar 29.

Characteristic Electrocardiographic Manifestations in Patients With COVID-19

Jia He  1 , Bo Wu  2 , Yaqin Chen  1 , Jianjun Tang  1 , Qiming Liu  1 , Shenghua Zhou  1 , Chen Chen  3 , Qingwu Qin  4 , Kang Huang  5 , Jianlei Lv  5 , Yan Chen  6 , Daoquan Peng  7
Affiliations
Case Reports

Characteristic Electrocardiographic Manifestations in Patients With COVID-19

Jia He et al. Can J Cardiol. 2020 Jun.

Abstract
in English, French

Cardiac involvement has been reported in patients with COVID-19, which may be reflected by electrocardiographic (ECG) changes. Two COVID-19 cases in our report exhibited different ECG manifestations as the disease caused deterioration. The first case presented temporary SIQIIITIII morphology followed by reversible nearly complete atrioventricular block, and the second demonstrated ST-segment elevation accompanied by multifocal ventricular tachycardia. The underlying mechanisms of these ECG abnormalities in the severe stage of COVID-19 may be attributed to hypoxia and inflammatory damage incurred by the virus.

Des cas d’atteinte cardiaque se manifestant par des changements décelables à l’électrocardiogramme (ECG) ont été rapportés chez certains patients atteints de la COVID-19. Nous exposons les cas de deux patients atteints de la COVID-19 dont les ECG révèlent une détérioration de la fonction cardiaque causée par la maladie. Dans le premier cas, le patient a présenté temporairement un aspect SIQIIITIII suivi d’un bloc auriculo-ventriculaire quasi complet réversible, tandis que dans le deuxième cas, le patient a présenté une élévation du segment ST accompagnée d’une tachycardie ventriculaire multifocale. Ces anomalies électroencéphalographiques chez des patients gravement atteints de la COVID-19 pourraient s’expliquer par l’hypoxie et les lésions inflammatoires provoquées par le virus.

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Figures

Figure 1
Figure 1
Electrocardiography series of patient 1: (A) Sinus rhythm with first-degree atrioventricular block (AVB); (B) sinus tachycardia, first AVB with SITIIIQIII; (C) Mobitz type 1 second-degree AVB and atrioventricular junctional escape beat; (D) high-grade AVB or nearly complete AVB with junctional escape rhythm; (E) first-degree AVB and recovery of SITIIIQIII.
Figure 2
Figure 2
Electrocardiography series of patient 2: (A) Sinus tachycardia with incomplete right bundle branch block; (B) slightly elevated ST segment; (C) ventricular tachycardia; (D) ventricular tachycardia and ventricular fusion; (E) remarkable ST-segment elevation in the form of triangular QRS-ST-T waveform.
See this image and copyright information in PMC

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