Abstract
Successful Conservative Management of COVID-19-Induced Fulminant Myocarditis
Bogoslovskaya Galina* and Bogoslovskiy Alexander
Corresponding Author: Bogoslovskaya Galina, Mankweng hospital, Limpopo province, South Africa.
Revised: August 03, 2023; Available Online: August 03, 2023
Citation: Galina B & Alexander B. (2023) Successful Conservative Management of COVID-19-Induced Fulminant Myocarditis. J Cardiol Diagn Res, 5(S1): 04.
Copyrights: ©2023 Galina B & Alexander B. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Share :
  • 2508

    Views & Citations
  • 1508

    Likes & Shares
Fulminant myocarditis (FM) is a severe clinical condition mainly characterized by rapidly progressive heart failure, arrhythmia, and hemodynamic instability. We describe the case of a young patient admitted for COVID‐19‐associated fulminant myocarditis. Optimal pharmacologic management with inotropic support had a successful outcome.

An 18-year-old female presented to the emergency department with febrile temperature, progressive exertional dyspnea, and low oxygen saturation in room A. Chest X-Ray showed multiple bilateral consolidations. A SARS-CoV-2 PCR was positive for SARS-CoV-2 RNA. The patient was admitted to the COVID ward and started Oxygen therapy with standard COVID-19 treatment. The next morning, she presented with recent onset of palpitations, low blood pressure, and symptoms of pulmonary edema. ECG demonstrated new-onset atrial fibrillation. Transthoracic echocardiogram showed global impairment in left ventricular systolic function with a left ventricular ejection fraction of 32%. Cardiac MRI (CMRI) demonstrated generalized severe myocarditis. The cardiac magnetic resonance image showed Lake Louise's criteria for myocarditis. As such, we diagnosed our patient with COVID-19-associated myocarditis based on CMRI appearances and positive SARS-CoV-2 swab. Admission in ICU, inotropic support, anti-failure medication, and amiodarone were added to her treatment with a favorable clinical response.

This case highlights that COVID-19-associated myocarditis can present as a new atrial fibrillation and heart failure with classic COVID-19-associated symptoms. The importance of this case in the demonstration of the severe cardiac involvement in a young patient without previous risk factors, positive for COVID-19, and the favorable response to the medical treatment given.

Keywords: COVID-19 fulminant myocarditis, Heart failure, Paroxysmal atrial fibrillation, Intensive care, Inotropic support