Atypical Manifestation of COVID-19-Induced Myocarditis

Area of Science:

• Cardiology
• Infectious Diseases
• Virology

Background:

• Myocardial injury is an emerging concern associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
• Coronavirus disease 2019 (COVID-19) typically presents with respiratory symptoms, but cardiac involvement is increasingly recognized.

Observation:

• A 39-year-old male presented with isolated chest pain and elevated troponin levels.
• Electrocardiogram (ECG) findings were inconclusive for ST-elevation myocardial infarction (STEMI), and coronary angiography revealed normal coronary arteries.
• The patient tested positive for COVID-19, leading to a diagnosis of COVID-19 myocarditis.

Findings:

• This case demonstrates COVID-19 myocarditis in a patient without typical respiratory symptoms or fever.
• The diagnosis was confirmed despite normal coronary arteries and inconclusive ECG findings for STEMI.
• The findings suggest SARS-CoV-2 can cause isolated cardiac injury, affecting non-respiratory organ systems.

Implications:

• COVID-19 should be considered in the differential diagnosis of unexplained myocarditis, even in the absence of respiratory symptoms.
• Physicians should maintain a high index of suspicion for cardiac manifestations of COVID-19.
• This case underscores the diverse clinical presentations of SARS-CoV-2 infection and its potential to affect multiple organ systems independently.