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

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COVID-19 and Acute Heart Failure: Screening the Critically Ill - A Position Statement of the Cardiac Society of Australia and New Zealand (CSANZ).
Heart, Lung and Circulation ( IF 2.6 ) Pub Date : 2020-05-01 , DOI: 10.1016/j.hlc.2020.04.005
Sean Lal ₁ , Christopher S Hayward ₂ , Carmine De Pasquale ₃ , David Kaye ₄ , George Javorsky ₅ , Peter Bergin ₄ , John J Atherton ₆ , Marcus K Ilton ₇ , Robert G Weintraub ₈ , Priya Nair ₂ , Mate Rudas ₁ , Lawrence Dembo ₉ , Robert N Doughty ₁₀ , Gayathri Kumarasinghe ₁₁ , Craig Juergens ₁₁ , Paul G Bannon ₁ , Nicole K Bart ₂ , Clara K Chow ₁₂ , Jo-Dee Lattimore ₁ , Leonard Kritharides ₁₃ , Richard Totaro ₁ , Peter S Macdonald ₂

Affiliation

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

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.

中文翻译：

COVID-19 和急性心力衰竭：筛查重症患者——澳大利亚和新西兰心脏病学会 (CSANZ) 的立场声明。

接受重症监护的 COVID-19 患者中，多达三分之一会发展为急性心肌病，这可能代表心肌炎或应激性心肌病。此外，虽然老年 COVID-19 患者的死亡率似乎与多器官衰竭并发急性呼吸窘迫综合征 (ARDS) 有关，但年轻患者的死因可能与急性心力衰竭有关。对于重症 COVID-19 患者，需要尽早考虑心脏受累，甚至在急性呼吸期过去之后。本声明提出了一种筛查算法，以更好地识别有严重心力衰竭和循环衰竭风险的 COVID-19 患者，同时平衡保护医护人员和保护个人防护设备 (PPE) 的需要。

更新日期：2020-05-01

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