Anagrelide Treatment and Congestive Heart Failure in the COVID-19 Era: A Case Report

Background: This case report emphasises the importance of differential diagnosis in dilated cardiomyopathy and the frequent misdiagnosis of congestive heart failure in the COVID-19 era. Case presentation: A patient with Polycythaemia Vera (PV) and no history of cardiac disease developed dyspnoea and radiological signs of pulmonary congestion. He was then treated as a suspected COVID-19 patient. However, echocardiogram showed biventricular dysfunction and severely reduced Left Ventricular Ejection Fraction (LVEF) (22%) without regional wall motion abnormalities. We hypothesised drug-related cardiotoxicity. Conclusion: Particular attention should be paid to patient admitted to Emergency Department (ED) with respiratory symptoms and clinical signs of congestion in order to correctly differentiate COVID-19 related respiratory disease from cardiogenic dyspnoea. Cardiotoxicity should always be ruled out in dilated-hypokinetic cardiomyopathy.