Why the study?
Viral-induced myocarditis has varied presentations from asymptomatic to fatal arrhythmias, making early recognition and treatment crucial to improve morbidity and mortality.
COVID-19 can induce fulminant myocarditis presenting with cardiogenic shock, rapid hemodynamic collapse, and sudden cardiac death, highlighting the need for early recognition using ECG and cardiac markers.
Recognition of syncope may signal myocarditis in recent COVID-19; extends sparse case reports but leaves open systematic study.
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.
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Guerra et al. (2022) studied this question.
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