Abstract
We report a case of myopericarditis associated to SARS-CoV-2 infection with necrotizing coronary vasculitis of intramural vessels, giving rise to biventricular apical microaneurysms and to electrical instability. Negativity of myocardial polymerase chain reaction for the most common cardiotropic viruses and for SARS-CoV-2 suggested an immune-mediated myocardial and pericardial inflammatory disease. High dose (1 mg/Kg daily) prednisone and anti-viral (Remdesivir, IDA Business, Carrigtohill, County Cork, T45 DP77, Ireland) therapy led to resolution of cardiac inflammation and ventricular arrhythmias. Morpho-molecular characterization of endomyocardial tissue may improve the outcome in subjects with SARS-CoV-2-associated myopericarditis and coronary vasculitis.
Highlights
Cardiac inflammation may occur during SARS-CoV-2 infection and even contribute to death of affected subjects [1]
We reported the case of a women with SARS-CoV-2 infection, who developed a myocarditis associated with vasculitis of intramural coronary vessels responsive to immunosuppressive treatment
The present report shows as necrotizing coronary vasculitis of intramural vessels may associate to myopericarditis in human coronavirus infection
Summary
Cardiac inflammation may occur during SARS-CoV-2 infection and even contribute to death of affected subjects [1]. We reported the case of a women with SARS-CoV-2 infection, who developed a myocarditis associated with vasculitis of intramural coronary vessels responsive to immunosuppressive treatment. Late gadolinium enhancement (LGE) imaging showed a subepicardial area in the infero-lateral wall on basal and midventricular planes (Figure 1C); corresponding mapping sequences documented a focal increase in native T1 values (Figure 1D), extracellular volume fraction (Figure 1E) and T2 mapping values (Figure 1F) consistent with diffuse edema and combined extracellular matrix expansion.
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