Emergency healthcare professionals fighting COVID-19

The acute cardiovascular care community has been on the front lines of the current health crisis and has a vital role to play. 

The Association for Acute CardioVascular Care wants to support the community and all healthcare professionals mobilised during this pandemic.

We have gathered a wide array of scientific resources that may help you.

ACVC Webinar: Acute Cardiovascular Care during the COVID-19 pandemic

Learning objectives

1. Diagnose and treat COVID-19 positive patients presenting with respiratory failure
2. Understand changes in diagnosis and treatment of patients admitted for acute coronary syndromes
3. Know how the pro-thrombotic situation associated with a COVID-19 infection may aggravate clinical outcome
4. Consider options of end-of-life decision in collapsing systems
5. Be informed about ongoing studies on how to fight the virus

Faculty

• Prof Kurt HUBER, FESC, Austria

Introduction and prothrombotic milieu in COVID-19 positive patients leads to an aggravation of clinical course caused by thrombotic events

• Prof Christian HASSAGER, FESC, Denmark

Respiratory failure – What is special?

• Prof Pascal VRANCKX, FESC, Belgium

Pre- and in-hospital care of ACS patients (including also protection from infection for healthcare workers)

• Prof Eric BONNEFOY-CUDRAZ, France

 Deciding end of life (when the system collapses)

• Dr Alexandru MISCHIE, FESC, France

Current research projects

Article selection from the EHJ-ACVC

• Acute Cardiovascular Care Association Position Paper on Intensive Cardiovascular Care Units: An update on their definition, structure, organisation and function
• Pneumonia and inflammation in acute decompensated heart failure: a registry-based analysis of 1939 patients
• Early signs of right ventricular systolic and diastolic dysfunction in acute severe respiratory failure: the importance of diastolic restrictive pattern
• Acute Cardiovascular Care Association position statement for the diagnosis and treatment of patients with acute myocardial infarction complicated by cardiogenic shock: A document of the Acute Cardiovascular Care Association of the European Society of Cardiology
• Implications for prehospital, emergency and hospital care in patients with ACS  
• Respiratory management in severe acute respiratory syndrome coronavirus 2 infection  
• Cardiac safety of off-label COVID-19 drug therapy: a review and proposed monitoring protocol  
• Medical treatment options for COVID-19
• The COVID-19 epidemic, its mortality, and the role of non-pharmaceutical interventions
• Ethical aspects of the COVID-19 crisis: How to deal with an overwhelming shortage of acute beds 
• Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic 

COVID-19 cases

The COVID-19 pandemic has led to an increase of severe cardiovascular events, which may be caused by the infection itself triggering a huge inflammatory response, with severe hypoxia and a systemic prothrombotic milieu as consequences.

These events include ST-elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarctions by plaque erosion or disruption and coronary thrombus formation, inflammation associated coronary spasms and TakoTsubo syndrome, and - in rare cases - myocarditis.

The cases presented below demonstrate such cardiovascular events that were clearly associated with a COVID-19 infection and aggravated the course of disease.

The cases originated from Italy, one of the European countries most affected by the COVID-19 pandemic.

 We need to thank our Italian colleagues for providing these reports, written in severe times under high physical and psychological pressure.

Prof. Kurt Huber, FESC, Austria

• COVID-19 - A usual case in an unusual situation, Claudio Montalto, Italy
• ST elevation in a COVID-19 positive patient, Luca Moderato, Italy 
• ST elevation in a COVID-19 patient with suspected Tako Tsubo, Luca Moderato, Italy

Intensive and Acute Cardiovascular Care Textbook

A selection of chapters that may be useful regarding COVID-19 patients.

• Acute dyspnoea in the emergency department
• Ethical issues
• Monitoring and investigations
• Procedures, especially relevant in this chapter are:
  
  • Mechanical ventilation
  • Renal support
  • Nutrition support
  • Physiotherapy in critically ill patients
• Acute respiratory failure and ARDS
• Acute kidney injury
• Infection, sepsis and multiorgan dysfunction syndrome
• Acute cognitive disorders
• Special considerations in the immunosuppressed patient
• Palliative care

 Videos

• Susanna Price - Acute Coronary Syndromes in COVID-19: How to get your unit ready
• Maddalena Lettino- Cardiac Care in the COVID-19 Pandemic
• Barbara Casadei - Acute Coronary Syndromes in COVID-19: Treatment considerations
• Hector Bueno - MI Patients - Too scared to go to the ER?

Recommended readings

• COVID-19-related myocarditis in a 21-year-old female patient
• Typical takotsubo syndrome triggered by SARS-CoV-2 infection
• Transient complete heart block in a patient with critical COVID-19