Rodriguez Guerra Miguel A, Lappot Ramona, Urena Ana P, Vittorio Timothy, Roa Gomez Gabriella
Medicine, Montefiore Medical Center Albert Einstein College of Medicine, Bronx, USA.
Internal Medicine, Center for Diagnosis, Advanced Medicine and Telemedicine (CEDIMAT), Santo Domingo, DOM.
Cureus. 2022 Apr 6;14(4):e23894. doi: 10.7759/cureus.23894. eCollection 2022 Apr.
Viral-induced myocarditis has different presentations, from being asymptomatic to fatal arrhythmias. It is crucial to recognize and treat this condition early to improve morbidity and mortality. We report a case of a 56-year-old male who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) three days ago and presented with syncope. The physical exam was relevant for right eyebrow laceration, tachycardia, and hypotension that responded to intravenous fluid, but two hours later, he had mental status changes, bradycardia, hypotension, and cardiac arrest. His repeated electrocardiogram (ECG) showed diffuse ST-segment elevation. Troponemia was evident in his blood work. Point-of-care ultrasound (POCUS) at the bedside showed dilated cardiomyopathy. Unfortunately, the patient re-arrested and needed advanced cardiovascular life support (ACLS). The initial assessment of SARS-CoV-2, serial ECGs, and cardiac markers are essential for a prompt approach and therapy in COVID-19-induced myocarditis.
病毒感染性心肌炎有不同的表现，从无症状到致命性心律失常。早期识别和治疗这种疾病对于改善发病率和死亡率至关重要。我们报告一例56岁男性病例，该患者三天前严重急性呼吸综合征冠状病毒2（SARS-CoV-2）检测呈阳性，出现晕厥。体格检查发现右眉部裂伤、心动过速和低血压，经静脉补液后症状有所缓解，但两小时后，他出现精神状态改变、心动过缓、低血压和心脏骤停。他多次心电图（ECG）显示广泛ST段抬高。血液检查显示肌钙蛋白血症明显。床旁即时超声（POCUS）显示扩张型心肌病。不幸的是，患者再次心脏骤停，需要高级心血管生命支持（ACLS）。对SARS-CoV-2的初步评估、系列心电图和心脏标志物对于COVID-19所致心肌炎的快速诊断和治疗至关重要。
