Int Heart J . Different Types of Myocardial Injury due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Variant

[tetano]

Int Heart J


. 2023 Jan 23.
doi: 10.1536/ihj.22-355. Online ahead of print.
Different Types of Myocardial Injury due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Variant


Keishi Moriwaki ¹ , Naoki Fujimoto ¹ , Hiroaki Murakami ¹ , Kazuaki Maruyama ² , Masaki Ishida ³ , Masaki Tanabe ⁴ , Kyoko Imanaka-Yoshida ³ , Kaoru Dohi ¹



Affiliations

• PMID: 36682768
• DOI: 10.1536/ihj.22-355

Abstract

Coronavirus disease 2019 (COVID-19) associated myocardial injury was caused by various mechanisms. We herein describe 2 cases presenting different types of myocardial injury due to Omicron variant. In both patients, diffuse reduced left ventricular (LV) wall motion in transthoracic echocardiography, electrocardiographic abnormality, and elevated myocardial enzymes were demonstrated. In addition, cardiovascular magnetic resonance (CMR) findings fulfilled the 2018 Lake Louise Criteria (LLC) for myocarditis. However, histological findings in 1 patient showed inflammatory cell infiltration with myocyte degeneration, while those in the other showed interstitial edema without inflammatory cell infiltration. Histological findings were crucial for a differential diagnosis of myocardial injury due to Omicron variant.

Keywords: COVID-19; Cardiovascular magnetic resonance; Histology; Myocarditis.

[Emily]

From the paper:

Case 1:A 64-year-old woman with a medical history of
hypertension and dyslipidemia presented with fever 6 days
prior to admission and dyspnea. She visited a nearby hos-
pital and was referred to our hospital because of the
changes in a 12-lead electrocardiogram (ECG), elevated
myocardial enzymes, and a positive SARS-CoV-2 antigen
test. She had received 2 doses of COVID-19 vaccination.

Case 2:A previously healthy 24-year-old man presented
to a local clinic due to a sore throat and fever 7 days
prior to admission. Antigen testing for SARS-CoV-2 was
negative. Although his symptoms were temporarily re-
lieved by antipyretic analgesics, he developed fever again
2 days prior to admission. As he experienced general mal-
aise and epigastric pain, he visited a nearby hospital. Be-
cause of a positive SARS-CoV-2 antigen test, an abnormal
electrocardiogram, and elevated myocardial enzymes, he
was referred to our hospital for admission. He had never
received COVID-19 vaccination.