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一名年轻健康男性的新冠病毒感染相关心肌心包炎

COVID-19 Myopericarditis in a Young Healthy Male.

作者信息

Bandeira Matilde, Serrazina Juliana, Santos Carolina António, Jacinto Nuno, Pais de Lacerda António

机构信息

Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.

Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.

出版信息

Eur J Case Rep Intern Med. 2022 May 23;9(5):003361. doi: 10.12890/2022_003361. eCollection 2022.

Abstract

UNLABELLED

SARS-CoV-2 infection can present in different clinical forms, most commonly as bilateral pneumonia, but also with pericardial/myocardial involvement. Cardiac involvement in COVID-19 is associated with worse outcomes. The authors report a case of myopericarditis as the primary manifestation of SARS-CoV-2 infection in a 20-year-old male patient with no known cardiovascular (CV) disorders or risk factors. The patient presented with pleuritic chest pain and high fever, with no respiratory symptoms. Electrocardiogram (ECG) and echocardiogram changes were consistent with pericarditis; concomitant elevation of cardiac enzymes revealed myocardial involvement. The patient had a slow but favourable evolution with no apparent impact on cardiac function. Other causes of myopericarditis were excluded and SARS-CoV-2 admitted as the most likely aetiological agent. This case highlights possible cardiac involvement in SARS-CoV-2 infection with little or no pulmonary disease in a young healthy patient. Such systemic and potentially troublesome manifestations of COVID-19 are increasingly being described.

LEARNING POINTS

Acute myopericarditis is a possible manifestation of SARS-CoV-2 infection.SARS-CoV-2 cardiac involvement may occur both in older and in younger previously healthy subjects, and could be more frequent than expected.Further investigation should address the prevalence of myocardium and pericardium involvement in COVID-19 patients, as well as its complications, sequelae and prognostic value for both older and young patients.

摘要

未标注

新型冠状病毒2型(SARS-CoV-2)感染可呈现不同的临床形式,最常见的是双侧肺炎,但也可伴有心包/心肌受累。新型冠状病毒肺炎(COVID-19)中的心脏受累与更差的预后相关。作者报告了一例20岁男性患者,以心肌炎作为SARS-CoV-2感染的主要表现,该患者无已知心血管疾病或危险因素。患者表现为胸膜炎性胸痛和高热,无呼吸道症状。心电图(ECG)和超声心动图改变与心包炎一致;心肌酶同时升高提示心肌受累。患者病情进展缓慢但预后良好,对心功能无明显影响。排除了心肌炎的其他病因,SARS-CoV-2被认为是最可能的病原体。该病例突出了在年轻健康患者中,SARS-CoV-2感染可能累及心脏,而肺部疾病很少或没有。越来越多的此类COVID-19全身及潜在麻烦的表现被描述。

学习要点

急性心肌炎是SARS-CoV-2感染的一种可能表现。SARS-CoV-2心脏受累可能发生在老年和年轻的既往健康受试者中,且可能比预期更常见。进一步的研究应关注COVID-19患者中心肌和心包受累的患病率,以及其对老年和年轻患者的并发症、后遗症和预后价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa53/9239031/8711a7c7ac58/3361_Fig1.jpg

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