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Review
. 2020 Nov;133(11):1254-1261.
doi: 10.1016/j.amjmed.2020.06.005. Epub 2020 Jul 10.

Cardiovascular Considerations for the Internist and Hospitalist in the COVID-19 Era

Michael R Massoomi  1 , R David Anderson  2 , Mustafa M Ahmed  1 , Osama Dasa  3 , Philip George Jr  1 , William M Miles  1 , Juan M Aranda Jr  1 , Carl J Pepine  1
Affiliations
Review

Cardiovascular Considerations for the Internist and Hospitalist in the COVID-19 Era

Michael R Massoomi et al. Am J Med. 2020 Nov.

Erratum in

Abstract

It is clear that existing cardiovascular disease is a major risk factor for COVID-19 and related adverse outcomes. In addition to acute respiratory syndrome, a large cohort also develop myocardial or vascular dysfunction, in part from inflammation and renin angiotensin system activation with increased sympathetic outflow, cardiac arrhythmias, ischemia, heart failure, and thromboembolic complications that portend poor outcomes related to COVID-19. We summarize recent information for hospitalists and internists on the front line of this pandemic regarding its cardiovascular impacts and management and the need for cardiovascular consultation.

Keywords: COVID-19; Cardiovascular consult; Cardiovascular disease; Multidisciplinary care; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

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Figures

Figure 1
Figure 1
Suggested algorithm for cardiac assessment of patients with COVID-19. BNP = brain natriuretic peptide; ECG = electrocardiogram.
Figure 2
Figure 2
Suggested algorithm for management of myocardial injury in patients in the COVID-19 era. ACS = acute coronary syndrome; ECG = electrocardiogram; STEMI = ST-segment elevation myocardial infarction.
Figure 3
Figure 3
Heart failure or COVID-19 virtual assessment guide. Adapted from Canadian Cardiovascular Society.
Figure 4
Figure 4
University of Florida Health algorithm for initiation of QTc prolonging drugs* in COVID-19 pathway. Modified from Giudicessi et al. *Hydroxychloroquine, chloroquine, azithromycin, lopinavir/ritonavir. ECG = electrocardiogram; EP = electrophysiology; SCD = sudden cardiac death; TdP = torsades de pointes.
See this image and copyright information in PMC

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