Bernal-Torres Wikler, Herrera-Escandón Álvaro, Hurtado-Rivera Manuel, Plata-Mosquera Carlos Andrés
Clinica DIME neurocardiovascular, Calle 4d Numero 89-36, Cali 760034, Colombia.
Eur Heart J Case Rep. 2020 Jul 8;4(FI1):1-6. doi: 10.1093/ehjcr/ytaa212. eCollection 2020 Oct.
Fulminant myocarditis is a catastrophic disease with high mortality and complications. A viral aetiology is frequent and the implication of SARS-CoV-2 is not yet known.
A 38-year-old woman who recently arrived from Spain presented with palpitations that started suddenly 3 days prior to presentation and were associated with haemodynamic instability, without dyspnoea or chest pain. We found features of myopericarditis on the electrocardiogram and severe systolic dysfunction on the echocardiogram. The chest tomography showed findings which suggested COVID-19 infection, and PCR for SARS-CoV-2 was positive. The cardiac magnetic resonance image showed Lake Louise criteria for myocarditis. The patient was treated with immunomodulatory, steroid, and immunoglobulin therapy, with a favourable clinical response.
The importance of this case lies in highlighting the severe cardiac involvement in a young patient, without previous risk factors, positive for COVID-19, and the favourable response to the medical treatment given.
暴发性心肌炎是一种具有高死亡率和并发症的灾难性疾病。病毒病因常见，而严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的影响尚不清楚。
一名38岁女性，近期从西班牙抵达，就诊前3天突然出现心悸，并伴有血流动力学不稳定，无呼吸困难或胸痛。我们在心电图上发现了心肌心包炎的特征，在超声心动图上发现了严重的收缩功能障碍。胸部断层扫描显示提示新型冠状病毒肺炎（COVID-19）感染的表现，SARS-CoV-2的聚合酶链反应（PCR）呈阳性。心脏磁共振成像显示符合心肌炎的路易斯湖标准。该患者接受了免疫调节、类固醇和免疫球蛋白治疗，临床反应良好。
该病例的重要性在于突出了一名无既往危险因素、COVID-19检测呈阳性的年轻患者出现的严重心脏受累情况，以及对所给予的药物治疗的良好反应。
