The viral myocarditis with cardiac аrrhythmia as complication of COVID-19 in the practice of family doctor of the tuberculosis dispensary

Abstract

BACKGROUND: About 70% of TB dispensary patients have chronic somatic diseases which not only prevent effective treatment of TB but also take progressive course themselves.

AIMS: To timely detect and treat acute and chronic somatic disease combined with TB.

MATERIALS AND METHODS: since 2020 the algorithm of patient complex investigation by specialists of therapeutic profile was developed in the Tuberculosis Dispensary No. 5, among them the general practitioner was the coordinator of the patient’s medical route. This became especially relevant during the COVID-19 pandemic.

RESULTS: In accordance with the developed algorithms of diagnostic search the patient was comprehensively examined. There were no signs of tuberculosis were in him, however the general practitioner involving to specialists team could diagnose signs of complex cardiac arrhythmia the probable cause which was a new coronavirus infection that he had had six weeks before.

CONCLUSIONS: The organization of a new form of medical service for phthisiatric patients allowed general practitioner to reveal serious cardiac pathology directly at the TB dispensary, to refer the patient for consultation to the cardiologist-arrhythmologist, to follow the patient and perform recommended cardiologic treatment simultaneously with measures or medical supervision over persons contacting with tuberculosis.

Keywords

miocarditis / cardiac arrhythmia / general practitioner / tuberculosis dispensary / complex examination / 24-hour ECG-monitoring / coronavirus infection / health organization

References

[1] Antonova TV, Zhevnerova NS. Viral myocarditis: etiology and pathogenesis, problems of diagnostics. Journal Infectology. 2013;5(2):13–21. (In Russ.). DOI: 10.22625/2072-6732-2013-5-2-13-21

[2] Антонова Т.В., Жевнерова Н.С. Вирусные миокардиты: этиология патогенез, проблемы диагностики // Журнал инфектологии. 2013. Т. 5, № 2. С. 13–21. DOI: 10.22625/2072-6732-2013-5-2-13-21

[3] Blagova OV, Nedostup AV, Kogan EA. Sindrom narushenii ritma i provodimosti serdtsa (“idiopaticheskie” aritmii) In: Bolezni miokarda i perikarda: Ot sindromov k diagnozu i lecheniyu. Moscow; 2019. P. 99–222. (In Russ.)

[4] Благова О.В., Недоступ А.В., Коган Е.А. Синдром нарушений ритма и проводимости сердца («идиопатические» аритмии) // Болезни миокарда и перикарда: От синдромов к диагнозу и лечению. М., 2019. С. 99–222.

[5] Kozlov IA, Tyurin IN. Cardiovascular complications of COVID-19. Messenger of Anesthesiology and Resuscitation. 2020;17(4):14–22. (In Russ.). DOI: 10.21292/2078-5658-2020-17-4-14-22

[6] Козлов И.А., Тюрин И.Н. Сердечно-сосудистые осложнения COVID-19 // Вестник анестезиологии и реаниматологии. 2020. Т. 17, № 4. С. 14–22. DOI: 10.21292/2078-5658-2020-17-4-14-22

[7] Inciardi RM, Lupi L, Zacoone G, et al. Cardiac involvement in a patient with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(7):819–824. DOI: 10.1001/jamacardio.2020.1096

[8] Inciardi R.M., Lupi L., Zacoone G. et al. Cardiac involvement in a patient with coronavirus disease 2019 (COVID-19) // JAMA Cardiol. 2020. Vol. 5, No. 7. P. 819–824. DOI: 10.1001/jamacardio.2020.1096

[9] Siripanthong B, Nazarian S, Muser D, et al. Recognizing COVID-19–related myocarditis: the possible pathophysiology and proposed guideline for diagnosis and management. Heart Rhythm. 2020;17(9):1463–1471. DOI: 10.1016/j.hrthm.2020.05.001

[10] Siripanthong B., Nazarian S., Muser D. et al. Recognizing COVID-19–related myocarditis: the possible pathophysiology and proposed guideline for diagnosis and management // Heart Rhythm. 2020. Vol. 17, No. 9. P. 1463–1471. DOI: 10.1016/j.hrthm.2020.05.001

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Yubrina I.V., Degtyareva L.N., Bozhkov I.A.