Key result
Focal myocarditis can present as the first clinical manifestation of a COVID-19 infection, even before the development of classic respiratory symptoms and with an initially negative PCR test.
Why the study?
Focal myocarditis as the first clinical manifestation of COVID-19 infection had not been reported previously.
Case Report (n=1)
No
Focal myocarditis can be the first clinical manifestation of COVID-19 infection, presenting similarly to an inferior STEMI.
Supports considering myocarditis in COVID-19 STEMI mimics; single case leaves open prevalence and management implications.
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Patients with COVID-19 typically present with symptoms and signs related to respiratory tract infection. However, a broad spectrum of cardiac manifestations including myocarditis has been reported as complications of this virus. Nevertheless, focal myocarditis as the first clinical manifestation of COVID-19 infection has not been reported before. Thus, we herein present the case of a 56-year-old male patient previously healthy and presented to the emergency department with chest pain. The clinical picture was compatible with inferior ST-elevation myocardial infarction (STEMI). Initial COVID-19 polymerase chain reaction (PCR) was negative, as well for its classic symptoms. Thereafter, further investigations suggested the diagnosis of focal myocarditis. Later on, the patient started to have a fever and repeated COVID-19 PCR that returned positive.
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Zayour et al. (2022) conducted a case report in Focal Myocarditis / COVID-19 (n=1). COVID-19 infection was evaluated on Clinical presentation and diagnosis. Focal myocarditis can present as the first clinical manifestation of a COVID-19 infection, even before the development of classic respiratory symptoms and with an initially negative PCR test.
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