Acute myocarditis as the main clinical manifestation of SARS-CoV 2 infection.

Gianluca Cuomo,Margherita Digaetano,Cristina Mussini,Federica Carli,Alessandro Raimondi,Guido Ligabue,Marianna Menozzi,Letizia Reggianini,Giovanni Guaraldi

doi:10.4081/idr.2020.8609

Gianluca Cuomo, Margherita Digaetano + Show 7 more

Open Access

https://doi.org/10.4081/idr.2020.8609

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Abstract

We describe a case of acute myocarditis, which was reported as the main COVID-19 clinical manifestation, with a favorabile outcome. In addition to symptoms, laboratory tests (BNP and troponin), echocardiogram and cardiac MRI contributed to diagnosis. Regardless heart biopsy was not obtained, it is likely an immunological pathogenesis of this condition which pave the way to further therapeutic implications, since there are currently no standardized treatments.

Highlights

Echocardiography Roberto Tonelli, Luca Tabbì, Riccardo Fantini, ly Abstract We describe a case of acute myocardin tis, which was reported as the main o COVID-19 clinical manifestation, with a favorabile outcome
We described a new case of COVID-16 related myocarditis with benign evolution
Cardiac Magnetic Resonance Imaging (MRI) performed on day 5, e showed slight depression of the ejection s fraction (54%), without significant alteru ations in the contractility of both ventricles l (Table 1), widespread increase in myocardial T2 signal intensity, moderate pericardial effuc sion at the posterior lateral wall of the left r ventricle (Figure 1)

Summary

Case Report

A 49-year-old Hispanic woman was admitted to the emergency room of the Modena University Hospital in March 2020 for fever, chest pain and cough lasting 3 days. A Chinese autoptic study that analyzed 68 deaths from SARS-CoV2 infection showed that 7% were due to myocardial damage or acute heart failure.[13] We described a new case of COVID-16 related myocarditis with benign evolution. Cardiac MRI performed on day 5, e showed slight depression of the ejection s fraction (54%), without significant alteru ations in the contractility of both ventricles l (Table 1), widespread increase in myocardial T2 signal intensity (ratio with skeletal ia muscle 2.2-2.5), moderate pericardial effuc sion at the posterior lateral wall of the left r ventricle (Figure 1). MRI of 2017,9,10 the patient had two clinical m presentation criteria (acute chest pain, newo onset of dyspnoea at rest or exercise, and/or c fatigue) and three diagnostic criteria

ED volume ES volume

Health Systems During the Coronavirus

Findings

Clinical predictors of mortality due to