Cardiogenic shock due to probable SARS-CoV-2 myocarditis: a case report

Martiene Klasen; Marije Smit; Maurits Renes; Kevin Damman; Joep M Droogh

doi:10.1093/ehjcr/ytad232

Cardiogenic shock due to probable SARS-CoV-2 myocarditis: a case report

Martiene Klasen, Marije Smit, Maurits Renes, Kevin Damman, Joep M Droogh^*

^*Corresponding author for this work

Cardiovascular Centre (CVC)

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: Since the start of the COVID-19 pandemic, many case reports have been presented describing different cardiac symptoms due to the SARS-CoV-2 infection. However, severe cardiac failure due to COVID-19 seems to be rare.

CASE SUMMARY: A 30-year-old woman presented with COVID-19 and cardiogenic shock due to a lymphocytic myocarditis. Since she deteriorated under treatment with inotropes, she was referred to our centre, and veno-arterial extracorporeal life support was started. Subsequently, the aortic valve only opened sporadically, and spontaneous contrast appeared in the left ventricle (LV), pointing towards difficulties with unloading LV. Therefore, an Impella for venting the LV was implanted. After 6 days of mechanical circulatory support, her heart function recovered. All support could be weaned, and 2 months later, she had made a full recovery.

DISCUSSION: We presented a patient with severe cardiogenic shock due to an acute virus-negative lymphocytic myocarditis associated with a SARS-CoV-2 infection. Since the precise aetiology of SARS-CoV-2-related myocarditis remains to be elucidated and no virus could be detected in the heart, a causal relationship remains speculative.

Original language	English
Article number	ytad232
Number of pages	4
Journal	European heart journal. Case reports
Volume	7
Issue number	5
DOIs	https://doi.org/10.1093/ehjcr/ytad232
Publication status	Published - May-2023

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title = "Cardiogenic shock due to probable SARS-CoV-2 myocarditis: a case report",

abstract = "BACKGROUND: Since the start of the COVID-19 pandemic, many case reports have been presented describing different cardiac symptoms due to the SARS-CoV-2 infection. However, severe cardiac failure due to COVID-19 seems to be rare.CASE SUMMARY: A 30-year-old woman presented with COVID-19 and cardiogenic shock due to a lymphocytic myocarditis. Since she deteriorated under treatment with inotropes, she was referred to our centre, and veno-arterial extracorporeal life support was started. Subsequently, the aortic valve only opened sporadically, and spontaneous contrast appeared in the left ventricle (LV), pointing towards difficulties with unloading LV. Therefore, an Impella for venting the LV was implanted. After 6 days of mechanical circulatory support, her heart function recovered. All support could be weaned, and 2 months later, she had made a full recovery.DISCUSSION: We presented a patient with severe cardiogenic shock due to an acute virus-negative lymphocytic myocarditis associated with a SARS-CoV-2 infection. Since the precise aetiology of SARS-CoV-2-related myocarditis remains to be elucidated and no virus could be detected in the heart, a causal relationship remains speculative.",

author = "Martiene Klasen and Marije Smit and Maurits Renes and Kevin Damman and Droogh, {Joep M}",

note = "{\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.",

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doi = "10.1093/ehjcr/ytad232",

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T1 - Cardiogenic shock due to probable SARS-CoV-2 myocarditis

T2 - a case report

AU - Klasen, Martiene

AU - Smit, Marije

AU - Renes, Maurits

AU - Damman, Kevin

AU - Droogh, Joep M

PY - 2023/5

Y1 - 2023/5

N2 - BACKGROUND: Since the start of the COVID-19 pandemic, many case reports have been presented describing different cardiac symptoms due to the SARS-CoV-2 infection. However, severe cardiac failure due to COVID-19 seems to be rare.CASE SUMMARY: A 30-year-old woman presented with COVID-19 and cardiogenic shock due to a lymphocytic myocarditis. Since she deteriorated under treatment with inotropes, she was referred to our centre, and veno-arterial extracorporeal life support was started. Subsequently, the aortic valve only opened sporadically, and spontaneous contrast appeared in the left ventricle (LV), pointing towards difficulties with unloading LV. Therefore, an Impella for venting the LV was implanted. After 6 days of mechanical circulatory support, her heart function recovered. All support could be weaned, and 2 months later, she had made a full recovery.DISCUSSION: We presented a patient with severe cardiogenic shock due to an acute virus-negative lymphocytic myocarditis associated with a SARS-CoV-2 infection. Since the precise aetiology of SARS-CoV-2-related myocarditis remains to be elucidated and no virus could be detected in the heart, a causal relationship remains speculative.

AB - BACKGROUND: Since the start of the COVID-19 pandemic, many case reports have been presented describing different cardiac symptoms due to the SARS-CoV-2 infection. However, severe cardiac failure due to COVID-19 seems to be rare.CASE SUMMARY: A 30-year-old woman presented with COVID-19 and cardiogenic shock due to a lymphocytic myocarditis. Since she deteriorated under treatment with inotropes, she was referred to our centre, and veno-arterial extracorporeal life support was started. Subsequently, the aortic valve only opened sporadically, and spontaneous contrast appeared in the left ventricle (LV), pointing towards difficulties with unloading LV. Therefore, an Impella for venting the LV was implanted. After 6 days of mechanical circulatory support, her heart function recovered. All support could be weaned, and 2 months later, she had made a full recovery.DISCUSSION: We presented a patient with severe cardiogenic shock due to an acute virus-negative lymphocytic myocarditis associated with a SARS-CoV-2 infection. Since the precise aetiology of SARS-CoV-2-related myocarditis remains to be elucidated and no virus could be detected in the heart, a causal relationship remains speculative.

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DO - 10.1093/ehjcr/ytad232

M3 - Article

C2 - 37215518

SN - 2514-2119

VL - 7

JO - European heart journal. Case reports

JF - European heart journal. Case reports

IS - 5

M1 - ytad232

ER -

Cardiogenic shock due to probable SARS-CoV-2 myocarditis: a case report

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