Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Apr 6;14(4):e23894.
doi: 10.7759/cureus.23894. eCollection 2022 Apr.

COVID-Induced Fulminant Myocarditis

Miguel A Rodriguez Guerra  1 , Ramona Lappot  2 , Ana P Urena  3 , Timothy Vittorio  4 , Gabriella Roa Gomez  5
Affiliations
Case Reports

COVID-Induced Fulminant Myocarditis

Miguel A Rodriguez Guerra et al. Cureus. .

Abstract

Viral-induced myocarditis has different presentations, from being asymptomatic to fatal arrhythmias. It is crucial to recognize and treat this condition early to improve morbidity and mortality. We report a case of a 56-year-old male who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) three days ago and presented with syncope. The physical exam was relevant for right eyebrow laceration, tachycardia, and hypotension that responded to intravenous fluid, but two hours later, he had mental status changes, bradycardia, hypotension, and cardiac arrest. His repeated electrocardiogram (ECG) showed diffuse ST-segment elevation. Troponemia was evident in his blood work. Point-of-care ultrasound (POCUS) at the bedside showed dilated cardiomyopathy. Unfortunately, the patient re-arrested and needed advanced cardiovascular life support (ACLS). The initial assessment of SARS-CoV-2, serial ECGs, and cardiac markers are essential for a prompt approach and therapy in COVID-19-induced myocarditis.

Keywords: coronavirus; fulminant myocarditis; myocarditis; sars-cov-2; sudden death.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Initial ECG
T-wave inversion and prolonged QTc in the inferior and antero-apical leads
Figure 2
Figure 2. Second ECG
New ST-segment elevation
Figure 3
Figure 3. POCUS showing a dilated cardiomyopathy evident in the apical four-chamber view
RV: right ventricle; LV: left ventricle; RA: right atrium; LA: left atrium
See this image and copyright information in PMC

References

    1. Viral myocarditis—from pathophysiology to treatment. Schultheiss HP, Baumeier C, Aleshcheva G, Bock CT, Escher F. https://doi.org/10.3390/jcm10225240. J Clin Med. 2021;10:5240. - PMC - PubMed
    1. Myocarditis and inflammatory cardiomyopathy: current evidence and future directions. Tschöpe C, Ammirati E, Bozkurt B, et al. https://doi.org/10.1038/s41569-020-00435-x. Nat Rev Cardiol. 2021;18:169–193. - PMC - PubMed
    1. Clinically suspected myocarditis in the course of severe acute respiratory syndrome novel coronavirus-2 infection: fact or fiction? Ozieranski K, Tyminska A, Jonik S, et al. https://doi.org/10.1016/j.cardfail.2020.11.002. J Card Fail. 2021;27:92–96. - PMC - PubMed
    1. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Caforio A L, Pankuweit S, Arbustini E et, al. al. https://pubmed.ncbi.nlm.nih.gov/23824828/ Eur Heart J. 2013;34:2636–2648. - PubMed
    1. Myocarditis. Cooper LT Jr. N Engl J Med. 2009;360:1526–1538. - PMC - PubMed

Publication types

LinkOut - more resources