Myocarditis with Complete Heart Block in a Child With COVID-19 Infection

Abstract

INTRODUCTION Severe acute respiratory syndrome coronavirus 2 (COVID 19), also known as COVID 19, was first detected in 2019 as a result of a cluster of pneumonia cases in China. It is known to cause respiratory illness in a majority of cases, however myocardial involvement can be seen in 7% of cases, with even a smaller number in pediatric populations. CASE PRESENTATION We are presented with a 14 year old male with confirmed COVID 19 infection that is followed by a fulminant myocarditis resulting in High grade AV Block and subsequent pacemaker insertion, which is the first reported case in the pediatric population. DISCUSSION Cardiac injury resulting from a recent COVID 19 infection can result to a fulminant myocarditis. This can present as arrhythmia, seen in 16.7% of cases. The mainstay of treatment is still maintaining hemodynamic stability and initiating immunomodulatory support, however, specifically in this case resulting in third-degree AV block, pacemaker insertion may also be required. CONCLUSION Although severe cardiac involvement in COVID 19 infection is rare, a fulminant myocarditis is possible for some patients. KEYWORDS COVID 19, Myocarditis, pacemaker, arrhythmia