COVID-19 Myocarditis Mimicking ST-Segment Elevation Myocardial Infarction

Introduction

The new SARS-CoV-2, that causes the coronavirus disease 2019 (COVID-19) has proven to be a virus that affect not only the respiratory system, but to cause several systemic manifestations, including cardiovascular ones. ^, Patients with previous cardiovascular disease who develop myocardial injury usually have worse outcomes, ^, such as acute coronary syndrome (ACS) ^, and myocarditis. ^– Myocarditis is mostly asymptomatic but can manifest with angina, cardiac failure, and arrythmias. ^–

The clinical diagnosis of myocarditis without the aid of complementary exams is usually difficult to be made. A meta-analysis with 2,866 with myocardial infarction without obstructive coronary artery disease (MINOCA) who underwent cardiac magnetic resonance (CMR) showed a prevalence of myocarditis of 34.5%. In COVID-19, a study carried out in Germany reported that 60% of recently recovered patients had signs of myocardial inflammation at CMR.

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