Paediatric Cardiology, Paediatric Heart Centre, University Children's Hospital Zurich, Switzerland.
Children's Research Centre, University Children's Hospital Zurich, Switzerland.
Swiss Med Wkly. 2022 Jul 28;152:w30214. doi: 10.4414/smw.2022.w30214. eCollection 2022 Jul 18.
We present an adolescent with cardiogenic shock due to ventricular tachycardia 2 weeks after SARS-CoV-2 infection. Acute myocarditis or myocardial dysfunction is associated with SARS-CoV-2 infection, but diagnosis may be difficult, even including endomyocardial biopsy.
A 15-year-old healthy adolescent was admitted to our hospital 2 weeks after SARS-CoV-2 infection with cardiogenic shock due to ventricular tachycardia. After cardioversion, antiarrhythmic treatment, ventilation, and inotropic support, the severely reduced myocardial function recovered completely within 2 weeks. Cardiac magnetic resonance imaging and cardiac catheterisation including right ventricular endomyocardial biopsy revealed an increased number of CD68+ macrophages in the myocardium, but nested (RT-) polymerase chain reaction (PCR) investigations revealed no viral or bacterial DNA/RNA.
SARS-CoV-2 infection may be associated with myocarditis leading to life-threatening arrhythmia and severe myocardial systolic and diastolic dysfunction, which may be short lasting and completely recover. Although former SARS-Cov-2 infection might suggest SARS-CoV-2-associated myocarditis, definite histological diagnosis including nested PCR investigations remains difficult.
我们报告了一例青少年在感染 SARS-CoV-2 后 2 周因室性心动过速引起的心源性休克。急性心肌炎或心肌功能障碍与 SARS-CoV-2 感染相关，但诊断可能具有挑战性，甚至包括心内膜心肌活检。
一名 15 岁健康的青少年在感染 SARS-CoV-2 后 2 周因室性心动过速引起的心源性休克被收入我院。电复律、抗心律失常治疗、通气和正性肌力支持后，严重降低的心肌功能在 2 周内完全恢复。心脏磁共振成像和包括右心室心内膜心肌活检的心脏导管术显示心肌中 CD68+巨噬细胞数量增加，但巢式（RT-）聚合酶链反应（PCR）研究未发现病毒或细菌 DNA/RNA。
SARS-CoV-2 感染可能与心肌炎相关，导致危及生命的心律失常和严重的心肌收缩和舒张功能障碍，这些可能是短暂的并完全恢复。尽管之前的 SARS-CoV-2 感染可能提示 SARS-CoV-2 相关心肌炎，但包括巢式 PCR 研究在内的明确组织学诊断仍然具有挑战性。
