COVID-19-associated myocarditis presenting as new-onset heart failure and atrial fibrillation.
Sean Paul GainePatrick DevittJohn Joseph CoughlanIan PearsonPublished in: BMJ case reports (2021)
A 58-year-old man presented to the emergency department with recent-onset palpitations and progressive exertional dyspnoea. ECG demonstrated new-onset atrial fibrillation. Transthoracic echocardiogram showed global impairment in left ventricular systolic function with left ventricular ejection fraction of 20%. Cardiac MRI (CMRI) demonstrated generalised severe myocarditis. A SARS-CoV-2 PCR was positive for SARS-CoV-2 RNA. As such, we diagnosed our patient with COVID-19-associated myocarditis based on CMRI appearances and positive SARS-CoV-2 swab. This case highlights that COVID-19-associated myocarditis can present as new atrial fibrillation and heart failure without the classic COVID-19-associated symptoms.
Keyphrases
- sars cov
- heart failure
- left ventricular
- atrial fibrillation
- left atrial
- aortic stenosis
- respiratory syndrome coronavirus
- ejection fraction
- emergency department
- cardiac resynchronization therapy
- coronavirus disease
- catheter ablation
- acute myocardial infarction
- hypertrophic cardiomyopathy
- oral anticoagulants
- direct oral anticoagulants
- multiple sclerosis
- left atrial appendage
- mitral valve
- acute heart failure
- magnetic resonance imaging
- percutaneous coronary intervention
- acute coronary syndrome
- case report
- early onset
- depressive symptoms
- transcatheter aortic valve replacement
- blood pressure
- heat stress
- magnetic resonance
- coronary artery disease