Сердечно-сосудистые осложнения в контексте COVID-19: нарушения ритма сердца

Пандемия COVID-19 стала глобальным кризисом беспрецедентного уровня для всего человечества. Весь процесс изучения заболевания (этиопатогенез, диагностика, лечение, профилактика, прогноз) был непростым, т. к. COVID-19 – это относительно новая нозология, с которой мир никогда не сталкивался. Сердечно-сосудистые осложнения при COVID-19 играют немаловажную роль в прогнозе заболеваемости и смертности. По мере распространения пандемии COVID-19 появляется все больше пациентов с нарушениями ритма сердца, артериальной гипертензией и прочими сердечно-сосудистыми осложнениями после перенесенной коронавирусной инфекции. Это может быть связано с воздействием коронавируса тяжелого острого респираторного синдрома (SARS-CoV-2) на дыхательную, сердечно-сосудистую и прочие системы, а также с развитием воспаления. Во время пандемии COVID-19 стало больше пациентов с аритмиями. По некоторым данным, риск развития аритмий при COVID-19 у госпитализированных пациентов варьирует от 7,57 до 17,97%. Основными причинами аритмии в контексте COVID-19 являются гипоксия (острый респираторный дистресс-синдром, тромбоэмболия легочной артерии, воздействие SARS-CoV-2 на хеморецепторы), миокардит (прямое и косвенное воздействие SARS-CoV-2 на миокард), электролитный дисбаланс, вегетативная дисфункция, используемые при COVID-19 кардиотоксичные препараты. Зачастую причин может быть несколько, и разобраться, какая именно стала основной для каждого пациента, достаточно трудно. В этом обзоре основное внимание уделяется потенциальным механизмам развития нарушений сердечного ритма у пациентов с COVID-19. Кардиологи, терапевты и врачи общей практики должны знать об особенностях сердечнососудистых осложнений при ведении пациентов с COVID-19, а также диспансеризации населения.

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