Luiz Antonio Neder FilhoUniversidade Nove de Julho, Brazil
Title: Heart failure secondary to myocarditis by COVID-19
Introduction: The susceptibility of SARS-CoV-2 to cause inflammatory responses in the myocardium has been observed. Although the existing literature on myocarditis secondary to the new coronavirus is scarce, the pathophysiology of this correlation is probably a combination of damage direct to cardiomyocytes. Among the possible sequelae of inflammation, chronic heart failure is the main long-term one.
Goals: To report a case of heart failure secondary to myocarditis in a patient affected by COVID-19, due to an inflammatory response of the SARS-CoV-2 virus, requiring oxygen therapy and no need for mechanical ventilation.
Methods: The information was obtained from a review of medical records and photographic records of the exams.
Results: A 42-year-old woman, hypertensive, diabetic, was admitted to the hospital complaining mainly of dyspnea. Patient reported that a few months ago she was diagnosed with COVID-19, in need of oxygen therapy and was hospitalized for 30 days, after 4 months of hospital discharge, she informs that she started with dyspnea on minor exertion, associated with paroxysmal nocturnal dyspnea, orthopnea and edema of the lower limbs. On magnetic resonance imaging, mild left ventricular systolic dysfunction, presence of discrete late enhancement of non-ischemic morphology and a pattern suggestive of inflammatory injury were observed; on the echocardiogram, signs suggestive of increased diastolic pressure; and left ventricular ejection fraction (LVEF) poststress myocardial scintigraphy was 63% and resting LVEF was 64%.
Conclusions: SARCS-CoV-2 can cause heart failure in secondary response to myocarditis, and this occurrence is rarely found in patients who do not have pre-existing heart problems. It is known that in order to have a good treatment, a good diagnosis is necessary to prevent other pathologies, such as cardiorespiratory arrest. In addition, a good anamnesis is of paramount importance, as it is easy to understand and quickly diagnose with the pathophysiological history
Luiz Antonio Neder Filho is a medical student and researcher in the field of Cardiology in Brazil