Covid-19 Combined with Stress Cardiomyopathy: Case Report and Review of the Literature

Introduction: Severe COVID-19 can cause multiple organ dysfunction or failure, often associated with cardiac dysfunction, known as stress cardiomyopathy or apical spherical syndrome. Patient Concerns: Severe COVID-19 patients in Hebei province have 5 cases of stress cardiomyopathy. Two cases in Cangzhou are summarized from Feb 2020 to May 2020. Diagnosis: Based on the precipitating factor, pathophysiology, Mayo diagnostic criteria and differential diagnosis of stress cardiomyopathy, the patients were diagnosed with stress cardiomyopathy, which is characterized by elevated biomarkers, hemodynamic instability, and cardiomyopathy. Interventions: Early and dynamic monitoring of ECG, myocardial enzymes, cardiac troponin and echocardiography are needed to predict and assess the risk of stress-induced cardiomyopathy. Noradrenaline and dobutamine were continued to be given, and neokine, levosimendan, Cediland and other drugs were given successively to strengthen the heart. Outcomes: After several days of supportive care, the patients’s cardiac output and the apical movement were gradually improved. Conclusion: Reversible stress cardiomyopathy may occur in the setting of COVID-19 infection with elevated cardiac biomarkers and an abnormal ECG and echocardiographic. We should pay more attention to the treatment of stress cardiomyopathy.