Rhythm and Conduction disturbances in patients with COVID-19 and their significance in family medicine practice

Abstract

SARS-Cov-2 (Severe acute respiratory syndrome coronavirus 2) belongs to the group of viruses containing ribonucleic acid (RNA). The most common clinical manifestations include fever, upper and/or lower respiratory tract involvement of varying severity. As the incidence of the disease increases and information about its course accumulates, it is known that there is an increased mortality from cardiovascular complications, including as a result of arrhythmias. It is assumed that the main mechanisms by which they occur are the entry of the virus into the heart cell through the expression of angiotensin-converting enzyme receptor 2, which leads to increased levels of angiotensin 2 and its many-sided negative effects, the development of a systemic inflammatory over-response (cytokine storm), directly cardiac damage, hypoxia, electrolyte disturbances, water imbalance. The disorders that are registered are tachyarrhythmias and bradyarrhythmias. In the conditions of the emerging COVID-19 (coronavirus disease of 2019) pandemic, general practitioners in Bulgaria played a significant role in the diagnosis and treatment of this disease. Of particular importance is their competence regarding the establishment of possible complications from the cardiovascular system. Knowledge of the most common rhythm and conduction disorders, as well as the mechanisms of their occurrence, are decisive for the correct management and their potential outcome.