A case of novel coronavirus (COVID-19)-induced viral myocarditis mimicking a Takotsubo cardiomyopathy

Yaser, Khalid; Dasu, Neethi; Dasu, Kirti

doi:10.1016/j.hrcr.2020.05.020

Cited by 11 publications

(7 citation statements)

References 9 publications

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“…ECG was normal in 4 patients 28,31,34,42 . In other patients, ECG findings were variable and ranged from sinus tachycardia (12 patients), ST‐segment elevation (14 patients), T‐wave inversion (12 patients), and ST‐depression in 7 patients.…”

Section: Resultsmentioning

confidence: 99%

“…ECG was normal in 4 patients. 28,31,34,42 In other patients, ECG findings were variable and ranged from sinus tachycardia (12 patients), ST-segment elevation (14 patients), T-wave inversion (12 patients), and ST-depression in 7 patients. In a few patients, arrhythmia was also reported, which included atrial fibrillation, 8 multiple premature ventricular complexes, 21 and supraventricular tachycardia.…”

Section: Ecg Findingsmentioning

confidence: 99%

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Myocarditis associated with Covid‐19 disease: A systematic review of published case reports and case series

Rathore¹,

Rojas

Sondhi

et al. 2021

Int J Clin Pract

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Background: Covid-19 is an extremely contagious illness caused by the severe acute respiratory syndrome (SARS-CoV-2) virus. The cardiac involvement in such a public health emergency disease has not been well studied and a conflicting evidence exists on this issue. Objective: This systematic review article aimed to compile and illustrate clinical characteristics, diagnostic findings, management, and outcomes manifesting in myocarditis linked with Covid-19. Methods: A literature search was accomplished for published eligible articles with MEDLINE/PubMed and Embase databases. All eligible case reports and case series were included from around the world without any language restrictions. For this review, inclusion criteria were laboratory-confirmed SARS-CoV-2 infection cases reporting a diagnosis of acute myocarditis. Results: Data from 41 studies describing myocarditis in 42 Covid-19 patients was obtained. The median age of these patients was 43.4 years, with 71.4% of them being men. Fever was the most prevalent presenting symptoms seen in 57% of patients. Hypertension was the most pervasive comorbidity accompanying these patients. Cardiac biomarkers troponin and brain natriuretic peptide (BNP) were raised in almost 90% and 87% of patients, respectively. Electrocardiogram findings were nonspecific and included ST-segment and T-wave changes. Echocardiogram commonly showed left ventricular systolic dysfunction with increased heart size. Cardiac magnetic resonance imaging (CMRI) exhibited myocardial edema and injury. The most prevalent histopathological feature appreciated was diffuse lymphocytic inflammatory infiltrates. Antivirals and corticosteroids were the most frequently used medications. About 38% of patients also needed vasopressor assistance. Out of 42 patients, 67% recovered, and eight died. Conclusion:Because of the risk of a sudden worsening of patients conditions and myocarditis association with considerable mortality and morbidity, a knowledge of this cardiac complication of Covid-19 disease is crucial for healthcare professionals.

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Section: Resultsmentioning

confidence: 99%

Section: Ecg Findingsmentioning

confidence: 99%

Myocarditis associated with Covid‐19 disease: A systematic review of published case reports and case series

Rathore¹,

Rojas

Sondhi

et al. 2021

Int J Clin Pract

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“…There are case reports of COVID-19 patients presenting with presumed acute myocarditis, many times of the fulminant type, however, there is paucity of confirmatory data via EMB and/or CMR. 51 -56 As mentioned, among 112 COVID-19 patients with ACI, as evidenced by elevated cTn, only 14 (12.5%) patients had abnormalities similar to myocarditis, such as triple elevation in cTnI with values over 0.12 ng/mL, plus abnormalities on echocardiography and/or ECG, albeit without CMR confirmation. 43 A systemic review of 14 patients with COVID-19-related myocarditis (median age 50.4 years) indicated a male predominance (58%), with HTN as the most prevalent comorbid condition (33%).…”

Section: Myocardial Injury In Covid-19mentioning

confidence: 93%

COVID-19 and Acute Myocardial Injury and Infarction: Related Mechanisms and Emerging Challenges

Manolis¹,

Manolis

et al. 2021

J Cardiovasc Pharmacol Ther

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In the era of the coronavirus disease 2019 (COVID-19) pandemic, acute cardiac injury (ACI), as reflected by elevated cardiac troponin above the 99th percentile, has been observed in 8%-62% of patients with COVID-19 infection with highest incidence and mortality recorded in patients with severe infection. Apart from the clinically and electrocardiographically discernible causes of ACI, such as acute myocardial infarction (MI), other cardiac causes need to be considered such as myocarditis, Takotsubo syndrome, and direct injury from COVID-19, together with noncardiac conditions, such as pulmonary embolism, critical illness, and sepsis. Acute coronary syndromes (ACS) with normal or near-normal coronary arteries (ACS-NNOCA) appear to have a higher prevalence in both COVID-19 positive and negative patients in the pandemic compared to the pre-pandemic era. Echocardiography, coronary angiography, chest computed tomography and/or cardiac magnetic resonance imaging may render a correct diagnosis, obviating the need for endomyocardial biopsy. Importantly, a significant delay has been recorded in patients with ACS seeking advice for their symptoms, while their routine care has been sharply disrupted with fewer urgent coronary angiographies and/or primary percutaneous coronary interventions performed in the case of ST-elevation MI (STEMI) with an inappropriate shift toward thrombolysis, all contributing to a higher complication rate in these patients. Thus, new challenges have emerged in rendering a diagnosis and delivering treatment in patients with ACI/ACS in the pandemic era. These issues, the various mechanisms involved in the development of ACI/ACS, and relevant current guidelines are herein reviewed.

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“…Mechanical circulatory support (V-V ECMO) was provided only in one patient (20). Thromboembolic events occured in 2 cases (17,25), arrhythmia in other 2 cases (38,42), and shock in 7 cases (19,22,23,25,26,29,33). Since sepsis and cytokine storm accompany the clinical course of severe COVID-19, it might be difficult to separate the hemodynamic effects of the underlying sepsis from TTS.…”

Section: Clinical Course and Outcomesmentioning

confidence: 99%

Takotsubo Syndrome During the COVID-19 Pandemic: State-of-the-Art Review

Moady¹,

Atar²

2021

CJC Open

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A case of novel coronavirus (COVID-19)-induced viral myocarditis mimicking a Takotsubo cardiomyopathy

Cited by 11 publications

References 9 publications

Myocarditis associated with Covid‐19 disease: A systematic review of published case reports and case series

Myocarditis associated with Covid‐19 disease: A systematic review of published case reports and case series

COVID-19 and Acute Myocardial Injury and Infarction: Related Mechanisms and Emerging Challenges

Takotsubo Syndrome During the COVID-19 Pandemic: State-of-the-Art Review

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