Acute Myocarditis Secondary to Paediatric Inflammatory Multisystem Syndrome Temporally Associated With COVID-19...

Area of Science:

• Pediatrics
• Cardiology
• Infectious Diseases

Background:

• Paediatric inflammatory multisystem syndrome (PIMS-TS) is a rare but serious condition associated with COVID-19.
• Myocardial involvement can occur in PIMS-TS, presenting with significant left ventricular dysfunction.

Observation:

• A previously healthy 17-year-old female presented with shortness of breath, diarrhea, and signs of shock.
• Initial investigations revealed impaired left ventricular systolic function (ejection fraction 35%) and elevated inflammatory markers.
• Despite negative SARS-CoV-2 PCR tests, a diagnosis of PIMS-TS was made based on clinical presentation and regional epidemiology.

Findings:

• The patient received intravenous immunoglobulin therapy, resulting in a rapid and positive clinical response.
• Left ventricular systolic function significantly improved, with ejection fraction recovering to 62% upon discharge.
• This case highlights the potential for severe cardiac manifestation in PIMS-TS, even with initial negative viral tests.

Implications:

• Early recognition and treatment of PIMS-TS are crucial for favorable outcomes, including cardiac recovery.
• This case underscores the importance of considering PIMS-TS in adolescents presenting with cardiac dysfunction and relevant exposure history.
• Further research into the cardiac manifestations and long-term sequelae of PIMS-TS in pediatric populations is warranted.