Abstract
Background Recent epidemiologic data has indicated coronavirus to be
highly contagious with high risk of person-to-person transmission. On
March 11, 2020, the World Health Organization (WHO) declared COVID-19 a
pandemic. With the increasing number of confirmed cases and the
accumulating clinical data, the cardiac manifestations induced by
COVID-19 have generated great concern. COVID-19 was also associated with
cardiac arrest, acute-onset heart failure, and myocarditis. COVID-19 has
not been reported as the cause of abnormalities of cardiac conduction
system. Case Presentation Our patient was transferred from a long-term
care facility with history of new onset bradycardia and fall. Patient
had no classical symptoms of viral infection, including fever, dyspnea
or any classical radiological finding like bilateral ground glass
opacities. Initial EKG was noted for 3rd degree AV and heart rate 30
BPM. He was taken to cardiac catheterization lab for an emergent
temporary transvenous pacemaker. Patient subsequently had permanent
pacemaker implanted electively. Discussion and Conclusions This case
represents cardiac conduction abnormality requiring therapeutic pacing
as a presenting symptom of SARS-CoV-2 Health care professionals need to
be vigilant about atypical, noval presentation of this disease in
patients belonging to risk groups such as over 60 years age,
immunocompromised, residents of long-term facilities, and with medical
conditions such as heart disease, lung disease, diabetes, stroke, renal
disease, cirrhosis, and diabetes. Currently there is no proven treatment
for this infection and individuals in these at-risk groups are
susceptible to higher morbidity and mortality.