Acute Lymphocytic Myocarditis in a Young Male Post-COVID-19

Area of Science:

• Cardiology
• Infectious Diseases
• Immunology

Background:

• Lymphocytic myocarditis is a rare cardiac condition linked to high mortality and sudden cardiac death.
• It can present as an extrapulmonary manifestation following coronavirus disease 2019 (COVID-19).

Observation:

• A 26-year-old male presented with fatigue, palpitations, and shortness of breath 8 weeks after a positive SARS-CoV-2 test.
• He had received COVID-19 mRNA vaccination 6 months prior.
• Echocardiography and cardiac magnetic resonance (CMR) revealed reduced left ventricular function and late gadolinium enhancement (LGE).

Findings:

• Endomyocardial biopsies confirmed acute lymphocytic myocarditis.
• Treatment included immunosuppression and a wearable cardioverter-defibrillator.
• Follow-up CMR showed slight improvement in systolic function, with persistent LGE.

Implications:

• Recognizing COVID-19-associated lymphocytic myocarditis is crucial.
• Vigilance for later-onset cardiomyopathy in COVID-19 patients is essential due to high mortality risks.
• Early diagnosis and management are vital for improving outcomes in post-COVID-19 cardiac complications.