Abstract
An outbreak of a severe respiratory illness caused by a novel coronavirus that began in China in late 2019 has become a pandemic. We report the case of COVID-19-associated myocarditis in a 45-year-old healthy female who presented with solely gastrointestinal symptoms. Initial investigations revealed ST-segment elevations in her electrocardiogram (EKG), elevated troponin levels, and a positive severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) reverse transcription-polymerase chain reaction (RT-PCR). Subsequently, she had rapid deterioration with the development of cardiogenic shock within hours of admission to a community hospital in Massachusetts. This case highlights an atypical presentation of COVID-19 with a fulminant course in this emerging and evolving disease.
Highlights
In December 2019, an outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in a seafood market in Wuhan, China [1]
We present a rare case of an otherwise healthy female patient who presented with gastrointestinal disturbances, STsegment elevations, and the development of fulminant myocarditis
This case, and many others with reported SARS-CoV-2 myocarditis, give insight into the importance of close monitoring in patients that present with elevated cardiac biomarkers as this may be an indicator for a poor prognosis
Summary
In December 2019, an outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in a seafood market in Wuhan, China [1]. A 45-year-old African female nursing assistant presented to the emergency department with four days of diarrhea, nausea, and vomiting She endorsed recent contact with COVID-19-positive patients. Vital signs showed a blood pressure of 113/85 mm Hg, heart rate of 116 beats per minute (bpm), respiration of 18 breaths per minute, a temperature of 96.0 degrees Fahrenheit, and oxygen saturation of 98% on room air Her examination was remarkable for an overweight, diaphoretic female in distress with abdominal tenderness and cold and clammy extremities. The patient initially received 2 liters of normal saline, hydroxychloroquine 400 mg, aspirin 325 mg, and atorvastatin 80 mg for presumptive COVID-19-associated myocarditis. She improved symptomatically and remained hemodynamically stable.
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