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  • Author
    Cindy La
  • Co-author

    Anthony Simone M.D., Joshua Ra M.D.

  • Title

    Case Report: COVID-induced myocarditis

  • Abstract

    A 26-year-old male with a past medical history notable for hyperlipidemia, COVID (Mid-December), and recent travel to Mexico, was admitted for abdominal pain, diarrhea, vomiting, fever with concerns for colitis. During the hospitalization, he was found to have a troponin that peaked to 9 with concern for myocarditis, acute decompensated heart failure with EF 30% and moderate-severe MR. The patient was diuresed and cardiac MRI and right heart catheterization with biopsy showed mild myocarditis with high numbers of eosinophils. Human coronavirus has been linked to myocarditis in patients of all age groups. There is thought that the pathophysiology of COVID-19–related myocarditis is a combination of direct viral injury and cardiac damage due to the cytotoxic host immune response. Clinical findings of COVID-19-related myocarditis include changes in electrocardiogram, cardiac biomarkers, poor cardiac function and symptomatic findings including chest pain, shortness of breath, fatigue, and arrhythmias. The viral RNAs of Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV, close relatives of SARS-CoV-2, were found in the heart tissues of infected animals, suggesting coronaviruses do possess some form of cardiotropism. However, at this time, there are no findings which suggest that there is direct infection and replication of SARS-CoV-2 in heart cells. The long-term impact of COVID-19 myocarditis remain unknown, but recent studies have suggested ongoing cardiac inflammation and other cardiac sequalae after COVID-19 that is independent of preexisting conditions. This indicates the need for better understanding of the pathophysiological mechanisms by which COVID-19 induces myocarditis and an investigation of the long-term cardiac complications of COVID-19. 

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