Syncope Associated with Sinus Nodal Dysfunction in a COVID-19 Patient: A Case Report and Review of the Literature

Andrew V. Doodnauth¹, Ahmad Jallad², Dahlia Rizk³, Emmanuel Valery¹ and Samy I. McFarlane^1,

¹Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States- 11203

²Division of Cardiovascular Medicine, Electrophysiology Section, State University of New York: Downstate Medical Center, Brooklyn, New York, United States- 11203

³Division of Hospital Medicine, Department of Medicine, Mount Sinai Beth Israel, Icahn School of Medicine NY, NY 10003

Cite this paper:
Andrew V. Doodnauth, Ahmad Jallad, Dahlia Rizk, Emmanuel Valery and Samy I. McFarlane. Syncope Associated with Sinus Nodal Dysfunction in a COVID-19 Patient: A Case Report and Review of the Literature. American Journal of Medical Case Reports. 2021; 9(4):263-267. doi: 10.12691/ajmcr-9-4-15

Abstract

COVID-19 caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is associated with significant cardiovascular dysfunction in patients with, and without, pre-existing cardiovascular disease [1]. There are now well-documented cardiac complications of COVID-19 infection which include myocarditis, heart failure, and acute coronary syndrome [2]. There is growing evidence showing that arrhythmias are also one of the major complications of COVID-19. We report a patient with no known cardiac conduction disease who presented with syncope, positive SARS-CoV-2 PCR, who was persistently bradycardic and subsequently developed sinus node dysfunction (SND). To date, there are a limited number of reports of sinus node dysfunction (SND) associated with COVID-19. We describe the clinical characteristics, potential pathophysiologic mechanisms and management of COVID-19 patients who experienced de novo SND.

Keywords:
COVID-19 SARS-CoV-2 bradycardic sinus node dysfunction (SND)

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References:

[1]	Peigh G, Leya MV, Baman JR, Cantey EP, Knight BP, Flaherty JD. Novel coronavirus 19 (COVID-19) associated sinus node dysfunction: a case series. Eur Heart J Case Rep. 2020 May 8; 4(FI1): 1-6.
[2]	Babapoor-Farrakhan S, Batnyam U, Wiener PC, Kanjanahattakij N, Khraisha O, Amanullah A, Mainigi SK. Atrioventricular and Sinus Node Dysfunction in Stable COVID-19 Patients. SN Compr Clin Med. 2020 Sep 4: 1-4.
[3]	Alabdulgader AA Sr, Alabdulgader A, Sungur M, Essa H, Al Khamees K Jr. Novel Behavior of the 2019 Novel Coronavirus with Invasion of the Cardiac Conduction System in the Young. Cureus. 2020 Oct 23; 12(10): e11115.
[4]	Gupta MD, Qamar A, Mp G, Safal S, Batra V, Basia D, Mandal SK, Yusuf J, Mukhopadhyay S, Bansal A. Bradyarrhythmias in patients with COVID-19: A case series. Indian Pacing Electrophysiol J. 2020 Sep-Oct; 20(5): 211-212.
[5]	Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004 Jun; 203(2): 631-7.
[6]	Cimino G, Pascariello G, Bernardi N, Calvi E, Arabia G, Salghetti F, Bontempi L, Vizzardi E, Metra M, Curnis A. Sinus Node Dysfunction in a Young Patient With COVID-19. JACC Case Rep. 2020 Jul 15; 2(9): 1240-1244.
[7]	Eid MM. COVID-19 patient with symptomatic bradycardia. Vis J Emerg Med. 2021 Jan; 22: 100920.