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Case Reports
. 2021 Jun:107:34-36.
doi: 10.1016/j.ijid.2021.04.013. Epub 2021 Apr 20.

COVID-19-related myocarditis post-heart transplantation

Stefan Roest  1 , Jasper J Brugts  1 , Jeroen J A van Kampen  2 , Jan H von der Thüsen  3 , Alina A Constantinescu  1 , Kadir Caliskan  1 , Alexander Hirsch  4 , Olivier C Manintveld  5
Affiliations
Case Reports

COVID-19-related myocarditis post-heart transplantation

Stefan Roest et al. Int J Infect Dis. 2021 Jun.

Abstract

This report describes the first heart transplantation recipient with acute biventricular heart failure symptoms caused by a post-myocarditis state, late after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. No other viral pathogens could be detected. Computed tomography angiography did not show cardiac allograft vasculopathy, and myocardial biopsy demonstrated no clinically relevant rejection. Subsequent cardiovascular magnetic resonance imaging revealed extensive epicardial delayed enhancement without myocardial edema. Heart failure medication was initiated and an implantable cardioverter defibrillator was implanted (due to non-sustained ventricular tachycardias), leading to a partial recovery of the ejection fraction. Further studies are needed to investigate the number of heart transplant recipients with myocardial damage after a SARS-CoV-2 infection.

Keywords: Acute heart failure; COVID-19; Heart transplantation; Magnetic resonance imaging.

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Figures

Figure 1
Figure 1
End-diastolic four chamber cine image (A) and four chamber (B) and mid-ventricle short axis (C) late gadolinium enhancement images showing a pattern of extensive subepicardial enhancement (white arrow heads) and several midwall to subepicardial spots of enhancement in the left ventricle (orange arrow heads) consistent with a post-myocarditis state.
See this image and copyright information in PMC

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