PMC7479482_01
(a) Chest X-ray at time of presentation, consistent with the diagnosis of SARS-CoV2. (b) EKG at time of presentation.
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On arrival to the ER, the patient was found to be tachycardic with a HR of 118 bpm (Figure 1(b)) and required 2-4 liters of supplemental oxygen. Chest XR revealed "bilateral predominantly peripherally distributed patchy opacities" (Figure 1(a)). A TTE done approximately 24 hours after the patient's respiratory decompensation revealed preserved left ventricular ejection fraction of 61% but with new apical hypokinesis. (Figure 3, Supplemental Video #1).
(a) EKG done approximately 12 hours after respiratory decompensation requiring intubation showing ST elevations and biphasic T waves. (b) EKG done approximately 48 hours after intubation showing marked QT prolongation. (c) Time course of QTc and hsTnT values after intubation.
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On the night of her respiratory decompensation and transfer to the ICU, a routine EKG was done and was remarkable for new repolarization abnormalities (Figure 2(a)). Over the following 48 hours, serial EKGs (Figures 2(b)-2(c)) showed continued persistence of T wave inversions and progressive prolongation in the QT interval. High-sensitivity troponin levels were checked at the time of the patient's initial respiratory decompensation and then again in the context of the EKG finding; there was biomarker evidence of cardiac injury which quickly resolved (Figure 2(c)).
Image of the apical view of transthoracic echocardiogram showing apical hypokinesis.
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A TTE done approximately 24 hours after the patient's respiratory decompensation revealed preserved left ventricular ejection fraction of 61% but with new apical hypokinesis. (Figure 3, Supplemental Video #1).