QTc Prolongation, Epiglottitis, Wavy Triple Sign, Wavy Double Sign (Yasser’s Signs), and Spike Sign Post-COVID Pneumonia in a Mitral Valve Prolapse; Bad Constellation and Good Outcome

Elsayed YMH

Published on: 2024-05-11

Abstract

Rationale; Corrected QT (QTc) interval prolongation is a hallmark for torsades de pointes (TdP), serious ventricular tachyarrhythmias, and sudden cardiac death (SCD). Corrected QT interval is an independent foreteller for all-cause mortality. Epiglottitis is a life-threatening inflammatory and infection condition of the epiglottis that causes profound swelling of the upper airways which can lead to asphyxia and respiratory arrest. Wavy triple and Wavy double ECG signs (Yasser’s sign) is new specific diagnostic and therapeutic signs seen in the cases of hypocalcemia. Corrected QT interval was related inversely with serum potassium and calcium. A Spike sign is the presence of small regular or irregular peaks between wide QRS complexes. Corrected QT (QTc) prolongation in COVID-19 is usually multifactorial. Patient concerns: A 15-year-old, adolescent male single student Egyptian patient was presented to the intensive care unit with stridor with QTc prolongation, hypocalcemia, and hypokalemia after COVID-19 pneumonia. Diagnosis: QTc prolongation, epiglottitis, Wavy triple sign, Wavy double sign (Yasser’s signs), and Spike sign post-COVID pneumonia in a mitral valve prolapse. Interventions: Chest X-ray, electrocardiography, echocardiography, and oxygenation. Outcomes: There is a good outcome despite the presence of several serious risk factors. Lessons: QTc prolongation, epiglottitis, Wavy triple sign of hypocalcemia, Wavy double sign of hypocalcemia (Yasser’s signs), hypokalemia, and Spike sign post-COVID pneumonia in a mitral valve prolapse are serious constellation serious risk factors. QTc prolongation is multifactorial. COVID pneumonia, hypocalcemia, hypokalemia, mitral valve prolapses, azithromycin, and oseltamivir are often implicated causes of the current QTc prolongation.