Cardiac emergencies during the COVID-19 pandemic in the light of the current evidence.

Sokolski, Mateusz; Sokolska, Justyna Maria; Zymliński, Robert; Biegus, Jan; Banasiak, Waldemar; Reczuch, Krzysztof; Ponikowski, Piotr

The burden of coronavirus disease of 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly increasing worldwide. The pathophysiology of the infection is associated with an increased inflammatory reaction which may lead to lung tissue damage and other disorders, affecting also the cardiovascular system. The clinical manifestations of the infection differ and depend mainly on the age and comorbidities. Cardiovascular involvement is associated with poor clinical course of the disease. The incidence of COVID-19 is higher in patients with cardiovascular diseases and risk factors. A significant challenge for the health care system during the ongoing pandemic is not only the treatment of COVID-19 patients and limitation of the spread of the infection, but also provision of proper care to all other patients. The latter is difficult due to the necessity of redistributing resources, limiting access to medical care and patients' fear of becoming infected, as a result of which they delay seeking medical help and avoid contacting medical services despite intensifying symptoms. Those factors determine a different profile of patients admitted to the hospital in acute cardiac conditions and also the modification of standard procedures, especially in relation to acute coronary syndrome, heart failure and pulmonary embolism. The crucial issue is to provide the optimal treatment and at the same time effectively protect the personnel and other patients against infection of SARS-CoV-2. The aim of this review is to provide comprehensive and up-to-date knowledge how to provide safe and efficient help in cardiac emergencies during the COVID-19 pandemic.