Regarding Covid 19

Coronavirus fulminant myocarditis saved with glucocorticoid and human immunoglobulin European Heart Journal, 37-year-old male patient was admitted to hospital on 14 January 2020, with chest pain and dyspnoea for 3 days, accompanied by diarrhoea. His blood pressure decreased to 80/50 mmHg. X-ray chest film showed significant enlargement of the heart (Panel A: cardiothoracic ratio 0.70). Chest computed tomography (CT) examination indicated pulmonary infection, enlarged heart, and pleural effusion (Panels B and C). The electrocardiogram suspected ST-segment elevation acute myocardial infarction (III, AVF ST-segment elevation, Panels D and E), an emergency CT coronary angiography revealed no coronary stenosis. Markers of myocardial injury were significantly elevated. Troponin T was more than 10 000 ng/L. Creatine kinase isoenzyme CKMB 112.9 ng/L. Natriuretic peptide BNP was up to 21 025 ng/L. Echocardiography revealed an enlarged heart and a marked decrease in ventricular systolic function left ventricular ejection fraction (LVEF) 27%, trace 2 mm pericardial effusion]. Sputum was examined for 13 viral nucleic acids related to respiratory tract. Only the coronavirus nucleic acid test was positive. All of the other 12 nucleic acid tests were negative, The diagnosis of this patient is coronavirus fulminant myocarditis with cardiogenic shock and pulmonary infection. Treatments include methylprednisolone to suppress inflammation (200 mg/day, 4 days), and immunoglobulin to regulate immune status (20 g/day, 4 days), norepinephrine to raise blood pressure, diuretic (toracemide and furosemide) to reduce cardiac load, milrinone to increase myocardial contractility, piperacillin sulbactam for anti-infection, pantoprazole, to inhibit gastric acid. After treatment, the patient’s symptoms improved significantly. One week later, X-ray chest film showed heart size normal (Panel F cardiothoracic ratio 0.49). Echocardiography showed that the size and function of the heart had returned to normal (LV 42 mm, LA 34 mm, RV 24 mm, RA 33 mm, LVEF 66%). Markers of myocardial injury dropped significantly after 1 week of treatment. Troponin T was 220.5 ng/L. Creatine kinase isoenzyme CKMB 9.14 ng/L. Natriuretic peptide BNP was 1587 ng/L. After 3 weeks, the myocardial injury markers had fully recovered to the normal range. In 2020, there was a major outbreak of coronavirus infection. Unlike other coronavirus infections, which mainly cause pulmonary infections, this case of coronavirus infection was characterized by heart damage.


Thank you for sharing doctor...
Frightening picture Awareness of the entity and high index of suspicion needed to make early diagnosis
Lucky man to come out of mouth of death Great work by colleagues
Informative post , Thank you Dr
Tnx for vital informations
Informative post
Good share

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