Elia Stefano, De Vecchi Simona, D'Amario Domenico, Patti Giuseppe
Department of Translational Medicine, University of Eastern Piedmont, Corso Mazzini 18, Padiglione A, Novara 28100, Italy.
Eur Heart J Case Rep. 2025 Feb 25;9(4):ytaf100. doi: 10.1093/ehjcr/ytaf100. eCollection 2025 Apr.
Post-acute sequelae of SARS-CoV-2 infection (PASC), commonly known as 'Long COVID-19', are progressively emerging in the population. While it was clear from the pandemic outbreak that pre-existing cardiac conditions were exacerbated by the infection even after its resolution, little is known about the rare cases of heart failure onset, whose mechanisms are still not fully understood.
A 74-year-old man was admitted to the emergency department with SARS-CoV-2 bilateral interstitial pneumonia at the computed tomography scan. A few months after, he developed acute myocarditis that slowly led to progressive myocardial fibrosis, systolic dysfunction, and a pro-arrhythmic state. Furthermore, these manifestations were associated with growing 'mental dullness' and chronic psychophysical asthenia. The patient underwent two cardiac MRI over 3 years witnessing the worsening of cardiac involvement and started full pharmacological therapy for heart failure. We report here the initial presentation, medical care, and clinical course of this patient.
In SARS-CoV-2 patients, long COVID-19-related myocarditis is one of the more severe complications. A thorough multimodal evaluation of these patients should be conducted, as presentation symptoms can appear subtle or misleading. Early identification of a chronic process of myocardial damage is crucial to implement early therapeutic strategies and prevent the potential worsening of heart failure.
新型冠状病毒2型感染的急性后遗症（PASC），通常被称为“长新冠”，在人群中逐渐显现。从疫情爆发时就很清楚，即使感染已痊愈，先前存在的心脏疾病仍会因感染而加重，但对于罕见的心力衰竭发病病例知之甚少，其发病机制仍未完全明确。
一名74岁男性因计算机断层扫描显示新型冠状病毒2型双侧间质性肺炎而入住急诊科。几个月后，他患上了急性心肌炎，逐渐发展为进行性心肌纤维化、收缩功能障碍和心律失常状态。此外，这些表现还伴有日益加重的“精神迟钝”和慢性身心虚弱。患者在3年内接受了两次心脏磁共振成像检查，结果显示心脏受累情况恶化，并开始接受心力衰竭的全面药物治疗。我们在此报告该患者的初始表现、医疗护理及临床病程。
在新型冠状病毒2型感染患者中，与“长新冠”相关的心肌炎是较为严重的并发症之一。应对这些患者进行全面的多模式评估，因为其表现症状可能较为隐匿或具有误导性。早期识别心肌损伤的慢性过程对于实施早期治疗策略和预防心力衰竭的潜在恶化至关重要。
