Giant inverted T waves in a patient with COVID-19 infection.

Manzur-Sandoval, Daniel; Carmona-Levario, Patricia; García-Cruz, Edgar

Abstract. The differential diagnosis of giant inverted T waves in the ECG includes, among others, Takotsubo syndrome (TTS). In a critically ill patient with acute hemodynamic or respiratory deterioration, a stress-related cardiomyopathy syndrome needs to be ruled out. In COVID-19 infection the main physiopathological mechanisms include systemic inflammatory response syndrome and thrombosis, which can condition cardiovascular complications. We present the case of a patient with COVID-19 infection who developed acute hemodynamic and respiratory collapse associated with giant inverted T waves in the ECG and regional wall motion abnormalities in the transthoracic echocardiogram. The resolution of these alterations after medical management supports the diagnosis of TTS caused by COVID-19 infection; to date, few cases of this association have been reported.