SARS-CoV-2 infection presenting as sustained atrial flutter and advanced ventricular dysfunction

Viral infections may affect the cardiovascular system in various ways. A number of viruses are known to cause myocarditis and pericarditis, which may result in severe impairment of ventricular function leading to decompensated heart failure [1]. Viral infections may also cause systemic inflammatory response syndrome and septic shock from exaggerated immune inflammatory response [2]. Certain viruses have also been linked to development of cardiac arrhythmias [3,4]. In these cases, evidence of myocardial inflammation is often found. However, arrhythmias are sometimes the only indicator of cardiac involvement in viral infections. Additionally, myocardial failure of any cause can raise atrial and ventricular filling pressures, resulting in increased myocardial fiber stress, potentially inducing arrhythmias or triggering arrhythmias.