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Review
. 2021 Apr;31(3):163-169.
doi: 10.1016/j.tcm.2020.12.007. Epub 2020 Dec 29.

Viral myocarditis: 1917-2020: From the Influenza A to the COVID-19 pandemics

Shereif H Rezkalla  1 , Robert A Kloner  2
Affiliations
Review

Viral myocarditis: 1917-2020: From the Influenza A to the COVID-19 pandemics

Shereif H Rezkalla et al. Trends Cardiovasc Med. 2021 Apr.

Abstract

Myocarditis is common during viral infection with cases described as early as the influenza pandemic of 1917, and the current COVID-19 pandemic is no exception. The hallmark is elevated troponin, which occurs in 36% of COVID patients, with electrocardiogram, echocardiogram, and cardiac magnetic resonance being valuable tools to assist in diagnosis. Cardiac inflammation may occur secondary to direct cardiac invasion with the virus, or to intense cytokine storm, often encountered during the course of the disease. Angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and judicious use of beta-blockers are beneficial in management of myocarditis. Corticosteroids may be avoided during the very early phase of viral replication, but can be of clear benefit in hospitalized, critically ill patients. Statins are beneficial to shorten the course of the disease and may decrease mortality.

Keywords: COVID-19; Coronavirus; Myocarditis; Pandemic; Troponin; Viral infection.

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Figures

Fig 1
Fig. 1
Suggested algorithm by the authors for diagnosis and management of viral myocarditis.
See this image and copyright information in PMC

Comment in

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