Heart block in Coronavirus 2019: A case Report

Introduction: One of the common extrapulmonary involvements in COVID-19 is the cardiovascular system. The reported cases of arrhythmias were mainly among patients with such symptoms as dyspnea, palpitation, chest tightness, and syncope. This study aimed to present a COVID-19 case with gastrointestinal symptoms who developed complete Atrioventricular (AV) block.

Case Presentation: The patient was a 19-year-old man with an active lifestyle and no previous illnesses who was admitted to the local hospital due to fever, fatigue, constipation, and one episode of syncope. In the primary evaluation, he had bradycardia and elevated C-Reactive Protein (CRP). In addition, the Real-Time fluorescence Polymerase Chain Reaction (RT-PCR) was positive for SARS-COV-2. Thus, he was referred to a tertiary hospital for management. The electrocardiogram revealed complete AV block and elevated cardiac troponin I level. However, echocardiography was normal. The patient was admitted to the intensive care unit and a temporary pacemaker was inserted. Then, the patient was transferred to the COVID ward and stayed there for nine days. During the admission, cardiac rhythm became sinusal and an improvement was observed in the patient’s general condition. Thus, he was discharged. In two weekly follow-up visits after discharge, the patient was asymptomatic and the ECG did not change. Follow-up echocardiography was also normal.

Conclusions: Cardiac involvement may occur in healthy individuals without cardiac risk factors and respiratory or cardiac presentations due to COVID-19 infection.