Cardiovascular manifestations of monkeypox virus outbreak: An overview of the reported cases

Monkeypox (Mpox) is a zoonotic DNA virus related to the orthopoxvirus family that causes also smallpox infection.

In this paper, we aimed to study the cardiovascular manifestations of Mpox.

A literature databases search was conducted on 20th October 2022 and limited to 2022 (the new outbreak) to collect all the relevant papers that discussed cardiovascular manifestations in Mpox.

The literature included 6 cases of myocarditis, one case of pericarditis, one case of myopericarditis and one case of atrial fibrillation. Of total 6 cases with completed data, ECG results and troponin levels were abnormal in 5 cases while only three cases had abnormal ECHO and CMR results. In the four cases who undergone chest X-rays, only one patient had non-specific retro-cardiac opacities. All patients (9 cases) recovered well from their cardiovascular manifestations with no deaths and only 3 of them required ICU admission.

With the limited reported cases, we recommend performing cardiovascular examinations -in particular ECG and troponin levels- in order to exclude cardiovascular insult in patients with suspected Mpox -cardiovascular involvement. However, in our series the infection was mild in most patients with no mortality.