Myocardial Fibrosis in a Recovered COVID-19 Patient: A Case Indicating Prior Myocarditis

We present a case of a 46-year-old man who was referred to the cardiology clinic for evaluation due to complaints of elevated blood pressure, dyspnea, and chest pain during physical activity for the past four months. The patient had coronavirus disease (COVID-19) five months ago. After the infection, he felt persistent fatigue, restless sleep, and difficulty breathing during physical activity for several months, but this condition gradually improved. Transthoracic echocardiography and magnetic resonance imaging were performed. Late gadolinium-enhanced imaging revealed subepicardial fibrosis limited to the basal and mid segments of the inferior and posterior walls of the left ventricle. This enhancement pattern was interpreted as non-ischemic in aetiology, suggestive of prior myocarditis, potentially related to COVID-19 infection. The patient was started on antihypertensive treatment, and as per the last follow-up, the patient's blood pressure remained well-controlled, with no other complaints. This case highlights the potential myocardial damage in COVID-19 survivors, highlighting the importance of post-viral cardiac assessment.