When to refer: Cardiac complications

Tutorial presented by Professor Zaheer Yousef, Consultant Cardiologist.

In this tutorial Professor Zaheer Yousef provides an overview of the cardiac complications of COVID-19, some of the symptoms that patients might present with, and the primary care workup of these patients.

Cardiac complications are usually seen in the patients with the more severe form of the disease, when they are admitted to hospital. During this period, there are three cardiac syndromes seen:

  1. Thromboembolic event/ Acute coronary syndrome
  2. Myocarditis
  3. Arrhythmias


During their inpatient stay, patients will have a management plan put in place before being discharged to the community. Reassuringly, major cardiac complications during COVID recovery are very rare, but the commonest presentation is that of Heart Failure. Patients presenting with the following symptoms should have a diagnosis of Heart failure considered:

  • Exertional breathlessness
  • Orthopnoea
  • Paroxysmal nocturnal dyspnoea
  • Ankle swelling
  • Fatigue

The primary care workup should include:

  1. Chest x-ray
  2. 12-lead-ECG
  3. Blood tests, including full blood count, electrolytes, CRP, Liver Function Tests, BNP and Troponin


In the presence of a normal BNP and normal 12-lead-ECG, it is extremely unlikely the patient has any serious cardiac pathology.

When to refer: Respiratory complications

When to refer: Neurological complications

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