Connection between COVID-19 and myocarditis discovered
The plot thickens, that COVID-19-diseases caused by the Coronavirus SARS-CoV-2, are associated with an increased risk for heart damage. On the basis of the current case report is to show the cardiologist that a patient during a COVID-19-disease developed a temporary heart weakness. The Doctors keep a heart muscle inflammation (myocarditis) for the most likely cause, which could be directly due to SARS-CoV-2 or as a result of the immune response emerged.
A case report of a patient in the cardiology clinic of the University of Brescia in the North of Italy, provides detailed information on what have been observed in several studies already. Cardiologist indoor and cardiologists describe the case of a 53-year-old patient, provides a possible explanation for why an above average number of COVID-19-Affected heart damage. The case report was presented in the prestigious journal “JAMA Cardiology”.
What complaints was the patient?
The 53-Year-old infected with the Coronavirus-SARS-CoV-2, and developed a few days later, fever and cough are the typical Symptoms of COVID-19. In the course of the disease, the Affected suffered from increasing fatigue. In one study, it was then found to have an acute Pumpschwäche of the heart muscle, which is why she was admitted to the cardiological clinic.
High Troponin levels in the blood
At the initial examination in the hospital, an increase of high-sensitive Troponin was found T. Cardiac Troponin is a protein complex that is excreted in the case of damage to the heart muscle into the blood and can be measured is. The presence of Troponin in the blood as a Marker of damage to heart muscle cells.
First, a heart attack was suspected
Because of high Troponin values indicate a heart attack, went to the Italian Doctors believed that such a cardiovascular event. However, in coronary angiography, neither stenosis nor occlusions of the coronary vessels could be found. So there was initially no explanation for the damaged heart muscle.
In a following, carried out echocardiography, a movement disorder of the heart was observed in muscle and in the heart-bag (pericardium), a limited effusion on the right ventricle found, although there were no further indications of cardiac tamponade (fluid or air accumulation in the pericardium). The left heart function reduced the damage by 40 percent.
The cause of further track, it was examined the patient by using a cardiac magnetic resonance imaging. Here is the suspicion that it is an interstitial Edema in the cardiac muscle was confirmed. Due to a delayed enrichment with the contrast agent Gadolinium and the Cardiologist were able to show and cardiologists, that an acute inflammation in the heart muscle was the most likely cause of the cardiac injury.
On the basis of the findings in the cardiac echo and MRI the treating Team comes to the conclusion that, most likely, an inflammation of the heart muscle (myocarditis), the weakness is the cause for the temporary heart. In the opinion of the cardiologist, this inflammation could have been triggered either directly by SARS-CoV-2 or as a result of an immune response to the Virus. The patient was treated with steroids, whereupon a improvement set. This also speak for inflammation as a cause of acute heart failure.
How has been treated the patient?
The medical team of the patient, dobutamine to improve heart function, and various drugs used for the treatment of heart failure, including Canrenone, furosemide, Bisoprolol and the ACE was. In addition, they received three days of intravenous steroids (methyl prednisolone). After six days the condition of the patient and the wall thickening of the heart improved, declined.
Heart damage were frequently observed
A recently published study from Wuhan, which offers the largest Overview of COVID-19-Affected, showed that around a fifth of over 400 COVID-19-patients and in -patients, an increase of cardiac Troponin in the blood was observed. This increase is associated with a significantly worsened prognosis of the disease process. For more information you can find in the article: COVID-19: In the case of Heart disease the risk is increased clearly.
In addition, a recent study by the University of Texas showed that a COVID-19-the disease will stay in people without previous heart disease can lead to damage to the heart. For more information, read the article: Coronavirus infection even in healthy people with heart damage associated. (vb)