Journal
EUROPEAN CARDIOLOGY REVIEW
Volume 18, Issue -, Pages -Publisher
RADCLIFFE CARDIOLOGY
DOI: 10.15420/ecr.2023.02
Keywords
COVID-19; PASC; post-acute sequelae of COVID-19; myocardial injury; myocarditis; cardiovascular magnetic resonance
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Post-acute cardiovascular sequelae of COVID-19 (PASC) is a recognized complication of severe acute respiratory syndrome coronavirus 2 infection, causing cardiac injury and inflammation, leading to long-term symptoms and health issues.
Lingering cardiac symptoms are increasingly recognised complications of severe acute respiratory syndrome coronavirus 2 infection, now referred to as post-acute cardiovascular sequelae of COVID-19 (PASC). In the acute phase, cardiac injury is driven by cytokine release and stems from ischaemic and thrombotic complications, resulting in myocardial necrosis. Patients with pre-existing cardiac conditions are particularly vulnerable. Myocarditis due to a direct viral infection is rare. Chronic symptoms relate to either worsening of pre-existing heart disease (PASC - cardiovascular disease) or delayed chronic inflammatory condition due to heterogenous immune dysregulation (PASC - cardiovascular syndrome), the latter affecting a broad segment of previously well people. Both PASC presentations are associated with increased cardiovascular risk, long-term disability and reduced quality of life. The recognition and management of PASC in clinical settings remains a considerable challenge. Sensitive diagnostic methods are needed to detect subtler inflammatory changes that underlie the persistent symptoms in PASC - cardiovascular syndrome, alongside considerable clinical experience in inflammatory cardiac conditions.
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