Right Ventricular Outflow Tract Tachycardia in a COVID-19 Patient: A
Case Report and Review of the Literature
Abstract
Objectives: The novel Coronavirus (SARS-CoV2) adversely affects cardiac
status and may cause arrhythmias. The objective of this study is to
describe the case of a 41 year-old female presenting to the emergency
department with Right ventricular outflow tract (RVOT) ventricular
tachycardia; as well as to appraise and compare etiologies proposed in
the literature with our case. Methods: The study design is a case report
and review of the literature. A PubMed/Medline search was conducted
including studies published in peer-reviewed journals between December,
2019 and November, 2020. Papers discussing the relationship between
COVID-19 and cardiac arrhythmias were included, excluding the pediatric
population and papers with major confounding factors to the
predisposition of cardiac arrhythmias. Results: 6 papers were included
in the qualitative synthesis. These papers discussed different
mechanisms by which COVID-19 can cause arrhythmias. These results were
compared with the findings in our case in an attempt to better
understand the etiology behind our case of RVOT-VT. Proposed etiologies
included ACE2-mediated direct damage of cardiomyocytes, raised serum CRP
levels, and raised systemic inflammatory markers and activation of the
Ca2+/Calmodulin protein kinase I. Conclusion: The lack of associated
comorbidities and risk factors in our patient highlights the unique
challenge of identifying the clinical sequelae of COVID-19. Proposed
pathophysiologies in the literature were not applicable to our case,
highlighting the need for clinical monitoring in patients, and the need
for further research on the topic.