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Fulminant COVID-19-Associated Myocarditis in an Otherwise Healthy Female

Gabriela C Milla-Godoy1, Robin Park1, Weizheng Jiang1

  • 1Internal Medicine, MetroWest Medical Center, Tufts University School of Medicine, Framingham, USA.

Cureus
|February 22, 2021
PubMed

Insights

This case study details a healthy 45-year-old female with severe COVID-19 presenting with only gastrointestinal symptoms. She rapidly developed myocarditis and cardiogenic shock, highlighting atypical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presentations.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • The COVID-19 pandemic, caused by SARS-CoV-2, has led to diverse clinical manifestations.
  • Myocarditis, or heart muscle inflammation, is a known but less common complication of SARS-CoV-2 infection.
  • Atypical presentations of COVID-19 can delay diagnosis and treatment, potentially worsening outcomes.

Observation:

  • A 45-year-old healthy female presented with exclusively gastrointestinal symptoms, initially masking a potential SARS-CoV-2 infection.
  • Electrocardiogram (EKG) revealed ST-segment elevations, and laboratory tests showed elevated troponin levels, indicative of cardiac injury.
  • A positive SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test confirmed the infection.

Findings:

  • The patient experienced rapid clinical deterioration within hours of hospital admission.
  • She developed cardiogenic shock, a life-threatening condition where the heart cannot pump enough blood to meet the body's needs.
  • This indicated a severe form of COVID-19-associated myocarditis.

Implications:

  • This case underscores the importance of considering COVID-19 in patients presenting with atypical symptoms, including gastrointestinal distress.
  • Fulminant myocarditis and cardiogenic shock can be rare but severe complications of SARS-CoV-2 infection.
  • Early recognition and aggressive management are crucial for improving outcomes in patients with severe COVID-19-associated cardiac complications.

Keywords:
cardiac troponincoronavirus disease 2019 (covid-19)fulminant myocarditis

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