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Cancha, J., (2020). Injuria miocárdica en paciente joven con COVID-19. Reporte de caso [Tesis, Universidad Privada Antenor Orrego - UPAO]. https://hdl.handle.net/20.500.12759/6906
Cancha, J., Injuria miocárdica en paciente joven con COVID-19. Reporte de caso [Tesis]. PE: Universidad Privada Antenor Orrego - UPAO; 2020. https://hdl.handle.net/20.500.12759/6906
@misc{renati/378106,
title = "Injuria miocárdica en paciente joven con COVID-19. Reporte de caso",
author = "Cancha Osorio, Jeannet Stefania",
publisher = "Universidad Privada Antenor Orrego - UPAO",
year = "2020"
}
Title: Injuria miocárdica en paciente joven con COVID-19. Reporte de caso
Authors(s): Cancha Osorio, Jeannet Stefania
Advisor(s): Aliaga Diaz, Roger Marcilio
Keywords: Troponina; SARS-CoV-2; COVID-19; Joven; Miocardio
OCDE field: http://purl.org/pe-repo/ocde/ford#3.02.04
Issue Date: 2020
Institution: Universidad Privada Antenor Orrego - UPAO
Abstract: Objetivo: Reportar un caso clínico infrecuente de injuria miocardica por estrés
asociada a COVID-19 (enfermedad por coronavirus 2019) en un paciente adulto
joven.
Materiales y métodos: Se analiza el caso de un paciente varón de 32 años que dio
positivo por COVID-19 con síntomas respiratorios altos y gastrointestinales en abril
del 2020. Hospitalizado por dolor precordial más disnea leve con diagnóstico de injuria
miocárdica confirmada por la elevación de troponinas I de 4.75 ng/ml (VN: <0.1ng/ml),
3 semanas después de la aparición de síntomas por COVID-19.
Resultados: El hallazgo en la tomografía de tórax mostró foco de atenuación de
vidrio deslustrado en lóbulo superior izquierdo. El electrocardiograma mostró
elevación mínima del punto J y segmento ST de 0,05 mv y taquicardia sinusal. El
ecocardiograma con función sistodiastólica biventricular conservada. Además para
detección y seguimiento de infección por coronavirus se realizó RT-PCR (prueba de
reacción en cadena de la polimerasa con transcripción inversa) de un hisopado
nasofaríngeo positivo en abril para COVID-19 y en mayo resultado negativo que
permitió reinserción laboral del paciente. Fue tratado con analgésico, corticosteroide
oral, betabloqueante, anticoagulante subcutáneo e ivermectina con estabilización
clínica y recuperación favorable.
Discusión: Los pacientes con COVID-19 que presentan dolor torácico y troponinas
positivas representan un gran desafío diagnóstico, la injuria miocardica producida por
el COVID-19, infrecuente en paciente jóvenes presenta un alto índice de
morbimortalidad por tener un cuadro clínico inespecífico por lo que es imprescindible
una detección y abordaje inmediato.
Conclusion: Se debe reconocer la interacción entre esta infección por el COVID-19 y
el daño miocardico, para detectar a tiempo las complicaciones cardiovasculares por
COVID-19, y ampliar esfuerzo en la necesidad de vigilancia de troponinas , detección
y tratamiento.
Objective: Report an infrequent clinical case of myocardial stress injury associated with COVID19 (coronavirus disease 2019) in a young adult patient. Materials and methods: The case of a 32-year-old male patient who tested positive for COVID-19 with upper respiratory and gastrointestinal symptoms in April 2020 is analyzed. Hospitalized for precordial pain plus mild dyspnea with a diagnosis of myocardial injury confirmed by an elevation of troponin I of 4.75 ng / ml(VN: <0.1ng/ml), 4 weeks after the onset of COVID-19 symptoms. Results: The chest tomography finding showed a ground glass attenuation focus in the left upper lobe. The electrocardiogram showed minimal elevation of the J point and ST segment of 0.05 mv and sinus tachycardia. Echocardiogram with preserved biventricular systodiastolic function. In addition, for detection and monitoring of coronavirus infection, RT-PCR (reverse transcription polymerase chain reaction test) was performed on a nasopharyngeal swab positive in April for COVID-19 and negative in May, which allowed the patient to return to work. The patient was treated with analgesic, oral corticosteroid, beta-blocker, subcutaneous anticoagulant, and ivermectin with clinical stabilization and favorable recovery. Discussion: Patients with COVID-19 who present with chest pain and positive troponins represent a great diagnostic challenge, myocardial injury caused by COVID19, infrequent in young patients, has a high rate of morbidity and mortality due to its non-specific clinical picture, so it is essential immediate detection and approach. Conclusion: The interaction between this COVID-19 infection and myocardial damage must be recognized, in order to detect cardiovascular complications due to COVID-19 in time, and expand efforts on the need for troponin surveillance, detection and treatment.
Objective: Report an infrequent clinical case of myocardial stress injury associated with COVID19 (coronavirus disease 2019) in a young adult patient. Materials and methods: The case of a 32-year-old male patient who tested positive for COVID-19 with upper respiratory and gastrointestinal symptoms in April 2020 is analyzed. Hospitalized for precordial pain plus mild dyspnea with a diagnosis of myocardial injury confirmed by an elevation of troponin I of 4.75 ng / ml(VN: <0.1ng/ml), 4 weeks after the onset of COVID-19 symptoms. Results: The chest tomography finding showed a ground glass attenuation focus in the left upper lobe. The electrocardiogram showed minimal elevation of the J point and ST segment of 0.05 mv and sinus tachycardia. Echocardiogram with preserved biventricular systodiastolic function. In addition, for detection and monitoring of coronavirus infection, RT-PCR (reverse transcription polymerase chain reaction test) was performed on a nasopharyngeal swab positive in April for COVID-19 and negative in May, which allowed the patient to return to work. The patient was treated with analgesic, oral corticosteroid, beta-blocker, subcutaneous anticoagulant, and ivermectin with clinical stabilization and favorable recovery. Discussion: Patients with COVID-19 who present with chest pain and positive troponins represent a great diagnostic challenge, myocardial injury caused by COVID19, infrequent in young patients, has a high rate of morbidity and mortality due to its non-specific clinical picture, so it is essential immediate detection and approach. Conclusion: The interaction between this COVID-19 infection and myocardial damage must be recognized, in order to detect cardiovascular complications due to COVID-19 in time, and expand efforts on the need for troponin surveillance, detection and treatment.
Link to repository: https://hdl.handle.net/20.500.12759/6906
Discipline: Medicina Humana
Grade or title grantor: Universidad Privada Antenor Orrego. Facultad de Medicina Humana
Grade or title: Médico Cirujano
Register date: 7-Dec-2020
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