Fulminant Myocarditis Following SARS-CoV-2 Infection: JACC Patient Care Pathways

Saurabh Rajpal; Rami Kahwash; Matthew S Tong; Kelly Paschke; Anjali A Satoskar; Beth Foreman; Larry A Allen; Nicole M Bhave; Ty J Gluckman; Valentin Fuster

doi:10.1016/j.jacc.2022.03.346

Fulminant Myocarditis Following SARS-CoV-2 Infection: JACC Patient Care Pathways

J Am Coll Cardiol. 2022 May 31;79(21):2144-2152. doi: 10.1016/j.jacc.2022.03.346. Epub 2022 Mar 29.

Authors

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. Electronic address: Saurabh.Rajpal@osumc.edu.
² Division of Cardiology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
³ Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
⁴ Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
⁵ Division of Cardiology, Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan, USA.
⁶ Center for Cardiovascular Analytics, Research, and Data Science (CARDS), Providence Heart Institute, Providence St. Joseph Health, Portland, Oregon, USA.
⁷ The Zena and Michael Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain.

Abstract

A 60-year-old woman with a past medical history of asthma presented with fulminant myocarditis 9 days after testing positive for SARS-CoV-2 and 16 days after developing symptoms consistent with COVID-19. Her hospital course was complicated by the need for veno-arterial extracorporeal membrane oxygenation, ventricular arrhythmias, and pseudomonas bacteremia. She ultimately recovered and was discharged to home with normal left ventricular systolic function. Thereafter, she developed symptomatic ventricular tachycardia, for which she received an implantable cardioverter-defibrillator and antiarrhythmic drug therapy.

Keywords: COVID-19; fulminant myocarditis; ventricular arrhythmias.

Publication types

Case Reports
Review

MeSH terms

Arrhythmias, Cardiac / complications
COVID-19* / complications
Critical Pathways
Extracorporeal Membrane Oxygenation*
Female
Humans
Middle Aged
Myocarditis* / diagnosis
Myocarditis* / etiology
Myocarditis* / therapy
SARS-CoV-2