Myocarditis Associated With COVID-19

Filip Oleszak¹, Andrii Maryniak¹, Evan Botti¹, Christian Abrahim², Moro O. Salifu¹, Mary Youssef¹, Victoria L. Henglein¹ and Samy I. McFarlane^1,

¹Department of Internal Medicine, State University of New York (SUNY): Downstate Health Science University, Brooklyn, New York, USA

²Division of Cardiology, Department of Internal Medicine, UMMS-Baystate Medical Center, Springfield Massachusetts, USA

Cite this paper

Filip Oleszak, Andrii Maryniak, Evan Botti, Christian Abrahim, Moro O. Salifu, Mary Youssef, Victoria L. Henglein and Samy I. McFarlane. Myocarditis Associated With COVID-19. American Journal of Medical Case Reports. 2020; 8(12):498-502. doi: 10.12691/AJMCR-8-12-19

Abstract

Coronavirus disease 2019 (COVID-19) has rapidly evolved into a global pandemic, with affecting to-date over 23 million people and causing over 800,000 deaths around the globe. The major pathogenetic mechanisms include inflammation, vasoconstriction and thrombogenesis. Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) typically manifests as fever, cough, shortness of breath, and exhibits radiographic evidence of bilateral pneumonic infiltrates. Recent meta-analyses have shown that myocardial injury, including viral myocarditis, is prevalent among infected patients, especially in patients requiring ICU level care. Diagnosis of viral myocarditis is multifactorial and involves detection of elevated cardiac biomarkers and echocardiographic evidence of cardiomyopathy, in the absence of diseased coronary arteries. Endomyocardial biopsy with histopathologic examination provides definitive confirmation. We present a case of a previously healthy 52-year-old male who presented clinically with suspected myocarditis with new-onset dilated cardiomyopathy (DCM) and systolic dysfunction as a sequela of infection with SARS-CoV-2. In this report we highlight the clinical presentation of echocardiographic findings and proposed pathogenetic mechanisms of myocarditis associated with COVID-19 which has a varied presentation, ranging from clinically silent to life-threatening arrhythmias with hemodynamic compromise.

Keywords

SARS-CoV-2, Myocarditis, COVID-19, Cardiac manifestations, Pathogenesis

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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