Studija slučaja

DELAYED MANIFESTATION OF POST-COVID MYOCARDITIS

IVA POPOV orcid.org/0000-0001-9225-5411 ; Sveučilište u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija; Institut za kardiovaskularne bolesti Vojvodine, Klinika za kardiologiju, Sremska Kamenica, Srbija
MILA KOVAČEVIĆ ; Sveučilište u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija; Institut za kardiovaskularne bolesti Vojvodine, Klinika za kardiologiju, Sremska Kamenica, Srbija
BRANISLAV CRNOMARKOVIĆ ; Sveučilište u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija; Institut za kardiovaskularne bolesti Vojvodine, Klinika za kardiologiju, Sremska Kamenica, Srbija
MILENKO ČANKOVIĆ ; Sveučilište u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija; Institut za kardiovaskularne bolesti Vojvodine, Klinika za kardiologiju, Sremska Kamenica, Srbija
MILANA JARAKOVIĆ ; Sveučilište u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija; Institut za kardiovaskularne bolesti Vojvodine, Klinika za kardiologiju, Sremska Kamenica, Srbija
STEVAN KEČA ; Institut za kardiovaskularne bolesti Vojvodine, Klinika za kardiologiju, Sremska Kamenica, Srbija
SONJA DIMIĆ ; Institut za kardiovaskularne bolesti Vojvodine, Klinika za kardiologiju, Sremska Kamenica, Srbija
SRĐAN MALETIN ; Sveučilište u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija; Institut za kardiovaskularne bolesti Vojvodine, Klinika za kardiologiju, Sremska Kamenica, Srbija
MILENA SPIROVSKI ; Sveučilište u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija; Institut za onkologiju Vojvodine, Sremska Kamenica, Srbija
MAJA STEFANOVIĆ ; Sveučilište u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija; Institut za kardiovaskularne bolesti Vojvodine, Klinika za kardiologiju, Sremska Kamenica, Srbija
MILOVAN PETROVIĆ ; Sveučilište u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija; Institut za kardiovaskularne bolesti Vojvodine, Klinika za kardiologiju, Sremska Kamenica, Srbija
ALEKSANDRA MILOVANČEVA ; Sveučilište u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija; Institut za kardiovaskularne bolesti Vojvodine, Klinika za kardiologiju, Sremska Kamenica, Srbija

Sažetak

: Myocardial involvement of coronavirus disease 2019 (COVID-19) varies and is considered to be more serious in patients with severe COVID-19 clinical presentation. Although myocarditis is usually recognized in the setting of acute SARS-CoV-2 infection, delayed manifestations are recognized as well. Case report. A 51-year-old male patient was admitted due to the clinical signs of congestive heart failure, two months after moderate clinical expression of COVID-19 pneumonia, treated as an outpatient. Transthoracic echocardiography (TTE) revealed dilated cardiomyopathy with the presence of diffuse left ventricular (LV) hypokinesia, severely reduced ejection fraction (EF 18%) and diastolic dysfunction with increased left atrial filling pressure. Baseline laboratory tests revealed elevated hs-troponin I, NT-proBN. Diagnostic workout excluded coronary artery disease. Cardiac magnetic resonance imaging strongly pointed in the direction of unrecognized post-COVID myocarditis. The patient was treated according to current guidelines for heart failure with reduced EF. Eight months after discharge, the patient had no limitations of physical activity and TTE showed significant improvement in the systolic function of the left ventricle, EF was 47%, with normal LV filling pressure. Conclusion: Myocarditis is not an infrequent manifestation of COVID-19 infection, especially in hospitalized patients with severe clinical presentation, and commonly manifests within the first week after initial symptoms. Our case report represents an example that also patients with mild form of COVID-19 treated as outpatients can have delayed onset of heart failure as a consequence of COVID-19-induced myocarditis. Therefore, COVID-19 patients deserve a comprehensive approach with systematic clinical and echocardiographic follow-up in order to establish a timely diagnosis, provide appropriate treatment, and prevent serious complications.

Ključne riječi

COVID-19; myocarditis; dilated cardiomyopathy; magnetic resonance imaging

Hrčak ID:

310552

URI

https://hrcak.srce.hr/310552

Datum izdavanja:

22.11.2023.

Podaci na drugim jezicima: hrvatski

Posjeta: 212 *