Acute Lymphocytic Myocarditis in a Young Male Post-COVID-19.

Autor: Bohné M; Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany., Bohnen S; Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany., Willems S; Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany., Klingel K; Cardiopathology, Institute for Pathology, University Hospital Tübingen, Tübingen, Germany., Kivelitz D; Department of Radiology, Asklepios Clinic St. Georg, Hamburg, Semmelweis University, Budapest, Asklepios CampusHamburg, Germany., Bahlmann E; Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany.
Jazyk: angličtina
Zdroj: Case reports in cardiology [Case Rep Cardiol] 2023 Jun 22; Vol. 2023, pp. 7646962. Date of Electronic Publication: 2023 Jun 22 (Print Publication: 2023).
DOI: 10.1155/2023/7646962
Abstrakt: Background: Lymphocytic myocarditis is a rare form of myocarditis, associated with a high mortality rate due to a high risk of sudden cardiac death. Lymphocytic myocarditis might present as a relevant extrapulmonary manifestation after coronavirus disease 2019 (COVID-19) infection. Case presentation . We report a case of a 26-year-old male with lymphocytic myocarditis, presenting with a 1-month history of increasing fatigue, palpitations, and shortness of breath. Eight weeks before, he was tested positive for SARS-CoV-2. He had received 2-dose schedule of the COVID-19 mRNA vaccine Comirnaty® (BioNTech/Pfizer) 6 months prior to his admission. Diagnostic work-up by echocardiography and cardiac magnetic resonance (CMR) imaging demonstrated a severely reduced left ventricular function and a strong midmyocardial late gadolinium enhancement (LGE). Histology and immunohistology of the endomyocardial biopsies revealed an acute lymphocytic myocarditis. Immunosuppressive therapy with a steroid taper in combination with azathioprine 300 mg/day was initiated. The patient was equipped with a LifeVest®. On day 17, a non-sustained ventricular tachycardia was documented. Follow-up CMR imaging after 3 months showed a slightly improved systolic left ventricular function, and a strong LGE was still detectable.
Conclusions: The case highlights the significance of recognizing lymphocytic myocarditis correlated to COVID-19. It is important to be vigilant also of a later presentation of cardiomyopathy in patients diagnosed with COVID-19 due to high mortality without immediate support.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2023 Mintje Bohné et al.)
Databáze: MEDLINE
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