Abstract
Cardiovascular system is one of the most vulnerable during COVID-19. The main mechanisms of cardiac injury are: direct myocardial damage, mediated by viral binding to angiotensin-converting-ensyme-2, cardiac microvascular damage and thrombosis, caused by hypercoagulability. Cardiovascular complications such as acute and chronic myocardial injury, myocarditis, myocardial infarction, pulmonary embolism, stress-cardiomyopathy, arterial and venous thrombosis and arrhythmic disorders are common among COVID-19 patients. Myocardial injury in COVID-19 could have different mechanisms and may occur at early and late stages of the COVID-19 disease, resulting in myocardial dysfunction and heart failure. Echocardiography is a first-line noninvasive imaging method to assess the cardiac injury during COVID 19 while cardiac magnetic resonance imaging is the best to identify myocardial oedema, inflammation and fibrosis. In this article we presented the analysis of experience of cardiologists in different countries concerning diagnostics ant treatment of COVID-19 related cardiovascular pathology and case reports from our own experience concerning cardiovascular complications of COVID-19. Laboratory diagnostics (troponin and brain-natriuretic peptide) and noninvasive imaging methods (echocardiography and cardiac magnetic resonance tomography) are essential to confirm the diagnosis of cardiac injury in COVID-19 and to evaluate the effect of the treatment. Long-term follow-up studies are needed to understand better the COVID-19 related cardiac pathology.