Division of Cardiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
ESC Heart Fail. 2022 Oct;9(5):3602-3607. doi: 10.1002/ehf2.14054. Epub 2022 Jul 9.
The case of a 35-year-old female with heart failure is presented, where the symptoms overlap with the heterogeneous manifestations of coronavirus disease 2019 (COVID-19). Those similarities and a recent shift in priorities during the SARS-CoV-2 pandemic delayed the recognition of acute heart failure in this patient. During the differential diagnostic process, obliterative disease was discovered in the bilateral subclavian and right renal arteries, and the latter resulted in uncontrolled hypertension, which played a significant role in the development of heart failure. The aetiology of vascular alterations turned out to be Takayasu's arteritis. Diagnosing Takayasu's arteritis is typically not straightforward due to its nonspecific signs and symptoms. Therefore, it can be concluded from our case report that the rising incidence of COVID-19 and focus on ruling out infection can potentially defer alternative, but appropriate diagnostic tests, particularly for certain conditions like rare diseases. Early identification and intervention is especially important for treating acute heart failure, whereas delay increases the risk of severe complications and mortality.
现呈现一例 35 岁女性心力衰竭病例，其症状与 2019 年冠状病毒病（COVID-19）的多种表现相重叠。这些相似之处以及 SARS-CoV-2 大流行期间最近优先级的转变，导致该患者的急性心力衰竭未能得到及时识别。在鉴别诊断过程中，发现双侧锁骨下动脉和右肾动脉存在阻塞性疾病，后者导致无法控制的高血压，这在心力衰竭的发展中起了重要作用。血管改变的病因被证实是大动脉炎。由于大动脉炎的症状不具特异性，因此其诊断并不简单。因此，从我们的病例报告可以得出结论，COVID-19 的发病率上升以及对感染的关注可能会延迟替代但合适的诊断测试，特别是对于某些罕见疾病等情况。早期识别和干预对治疗急性心力衰竭尤为重要，而延迟则会增加严重并发症和死亡的风险。
