Khine Su, Edupuganti Srujan, Bachuwa Ghassan
Department of Internal Medicine, Hurley Medical Center, Flint, Michigan, USA.
Department of Internal Medicine-Pediatrics, Hurley Medical Center, Flint, Michigan, USA.
Eur J Case Rep Intern Med. 2023 Aug 2;10(9):003877. doi: 10.12890/2023_003877. eCollection 2023.
Coronavirus 19 (COVID-19) is well known for causing acute respiratory distress syndrome. Among other systemic complications, myocarditis is a frequently reported presentation as well as complication. One systematic review reported a 14% mortality rate in patients with COVID-19 myocarditis. Endomyocardial biopsy is a definitive diagnostic test but has been a challenge to perform in most cases of COVID myocarditis due to the contagious nature of the disease. Patients presenting with new cardiomyopathy with troponin leak and arrhythmias, supported by recent COVID-19 diagnosis should be suspected for COVID-induced myocarditis. Supportive treatment has been the mainstay of treatment with limited data on immunotherapy and colchicine. Our case is about a male in his 50s who had a cardiac arrest due to ventricular fibrillations, with a positive COVID-19 test. Further workup showed severe non-ischaemic cardiomyopathy with an EF of 15-20%. He was treated with intravenous immunotherapy and colchicine. A repeat echocardiogram 3 days later showed resolution of cardiomyopathy. Our case report highlights the possible beneficial effects of immunotherapy and colchicine in viral myocarditis.
Myocarditis should be suspected in patients with acute onset cardiomyopathy with troponin leak and no evidence of ischaemia. COVID-19 myocarditis can present with arrhythmia, which could be fatal in some cases.Even though supportive management is the mainstay of treatment for COVID-19 myocarditis, there have been reports of benefits of intravenous immunotherapy (IVIG) and colchicine.More studies are warranted to explore the beneficial effects of IVIG and colchicine not just in COVID-19 myocarditis, but also in other viral causes of myocarditis he aim of this study is also to raise awareness among healthcare professionals about the Bentall procedure in patients with type A aortic dissection involving the aortic valve.
新型冠状病毒19（COVID-19）以引发急性呼吸窘迫综合征而闻名。在其他全身并发症中，心肌炎也是一种常见的表现及并发症。一项系统评价报告称，COVID-19心肌炎患者的死亡率为14%。心内膜心肌活检是确诊的诊断性检查，但由于该疾病具有传染性，在大多数COVID心肌炎病例中进行此项检查具有挑战性。近期COVID-19诊断支持下，出现伴有肌钙蛋白泄漏和心律失常的新发心肌病患者应怀疑为COVID-19诱发的心肌炎。支持性治疗一直是主要治疗方法，关于免疫疗法和秋水仙碱的数据有限。我们的病例是一名50多岁男性，因室颤发生心脏骤停，COVID-19检测呈阳性。进一步检查显示严重非缺血性心肌病，射血分数为15%-20%。他接受了静脉免疫疗法和秋水仙碱治疗。3天后复查超声心动图显示心肌病有所缓解。我们的病例报告强调了免疫疗法和秋水仙碱在病毒性心肌炎中可能的有益作用。
对于急性发作的伴有肌钙蛋白泄漏且无缺血证据的心肌病患者，应怀疑患有心肌炎。COVID-19心肌炎可表现为心律失常，在某些情况下可能致命。尽管支持性治疗是COVID-19心肌炎的主要治疗方法，但已有静脉免疫球蛋白（IVIG）和秋水仙碱有益作用的报道。需要更多研究来探索IVIG和秋水仙碱不仅在COVID-19心肌炎中的有益作用，还包括在其他病毒性心肌炎病因中的作用。本研究的目的还在于提高医护人员对累及主动脉瓣的A型主动脉夹层患者进行Bentall手术的认识。
