Since the WHO defined the diffusion of novel coronavirus, Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) as pandemic, the global effort has been on finding a cure and preventing transmission. As a consequence, people are going through many psychological problems in adjusting to the current lifestyles and fear of the disease. The link between the psychological effects of quarantine and arrhythmias has been poorly explored. However it is known that sudden catastrophic events i.e. earthquake are associated with an increase in sudden cardiac deaths. Acute stress and anxiety could act as a trigger for ventricular arrhythmias, which are found to have increased significantly after an earthquake. Quarantine induced a chronic stress enforced by alarming news reports in the media. Closure of businesses increased the stress due the expected crisis after the lockdown. Stress activates both the sympathetic nervous system and the axis of the renin-angiotensin-aldosterone system, leading to an increased risk of cardiac events. The aim of the present editorial is to analyze the potential impact of quarantine –induced stress on the development of arrhythmias.
Despite advancement in therapy and management, left ventricular thrombus (LVT) after anterior myocardial infarction (MI) is sporadically encountered and remains associated with a very high risk of major cardiovascular events and mortality. Cardiac magnetic resonance (CMR) is considered the gold standard technique for LVT detection, but it is a time consuming and expensive test not available in all centers, especially when repeated exams are necessary. Transthoracic echocardiography represents a useful tool to screen for LVT and to identify predictors of high risk of developing LVT. The advances in ultrasound technology and the use of contrast agents may potentially help clinicians to identify LVT and the use of sequential echocardiography for each patient with acute MI complicated by LVT may provide an opportunity to quantify regression and its correlation with outcomes to tailor the management of these patients. Hence, this narrative review focuses on the added value of echocardiographic-guided LVT management in patients with recent anterior MI to reduce mortality and morbidity excess related to LVT based on current evidence.