Introduction:
The World Health Organization declared COVID-19 a pandemic on March 11,
2020 (1). As of mid-August 2020, there have been about 21,250,743
confirmed cases worldwide with 766,648 deaths reported across the globe,
based on the Center for Systems Science and Engineering at Johns Hopkins
University (2). This novel coronavirus has been shown to have
cardiovascular manifestations in the form of arrhythmias (3), conduction
disturbances (4), myocarditis (5), stress cardiomyopathy (6), myocardial
injury (7) and myocardial ischemia or infarction from increased
microvascular and/or macrovascular coagulopathy (8, 9). However, in
addition to these direct effects, we are now starting to recognize
indirect cardiovascular effects of COVID-19 in the form of increased
incidence of Takutsobo cardiomyopathy in patients without any evidence
of coronavirus infection. Based on a retrospective cohort analysis from
Ohio, acute coronary syndrome resulting from stress cardiomyopathy was
found to be much higher during the pandemic (about 8%) period, compared
to similar times periods before the pandemic (about 1.5-2%) (10). This
increase in stress cardiomyopathy is likely resulting from increased
emotional and psychological stress related to social isolation, which is
further exacerbated by the economic consequences of the shut-down. In
this article, we present a case series of two such patients diagnosed
with stress cardiomyopathy caused by psychological trauma due to the
ongoing pandemic.