SHM Converge Scientific Abstract ePoster Gallery-Late-Onset Myocarditis Post Covid-19 Infection

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This case report describes a 51-year-old morbidly obese man with no significant prior medical history who developed late-onset myocarditis and non-ischemic cardiomyopathy after COVID-19 infection. He had been hospitalized for COVID-19 three months earlier and later presented with one month of worsening dyspnea on exertion, orthopnea, and paroxysmal nocturnal dyspnea.<br /><br />Initial evaluation showed elevated high-sensitivity troponin (66 ng/L) and BNP (554 pg/ml), with sinus tachycardia on ECG. Chest X-ray was unremarkable. Transthoracic echocardiography revealed severe left ventricular systolic dysfunction with an ejection fraction of 15–20% and no wall motion abnormalities. Left heart catheterization found no significant coronary artery disease, supporting a diagnosis of non-ischemic cardiomyopathy likely secondary to COVID-19-induced myocarditis.<br /><br />He was treated with guideline-directed medical therapy, including metoprolol, sacubitril-valsartan, and empagliflozin, along with diuretics to achieve euvolemia. His symptoms improved significantly, and he was discharged home. On follow-up three months later, he was symptom-free, and repeat echocardiography showed recovery of ejection fraction to 40–45%.<br /><br />The report emphasizes that COVID-19 can cause myocardial inflammation and dysfunction even weeks to months after the initial infection. While most cases of COVID-related myocarditis occur early, this case demonstrates a delayed presentation approximately two months after infection. The authors stress the importance of prolonged surveillance after COVID-19 recovery to enable early recognition and treatment of delayed cardiac complications.

Asset Subtitle

Noor Ul Ain

Meta Tag

Author List Abu Hurera, Aleesha Kainat, Anjana Chandrasekhara Pillai, Noor Ul Ain

Category Clinical Vignettes

Concept COVID-19

Concept Myocarditis

Concept Heart Failure

Concept Troponin

Concept Cardiomyopathy

Distinguished Non-Finalist

Presenter Organization Department of General Internal Medicine, University of Pittsburgh Medical Center, McKeesport

Presenting Author Noor Ul Ain

Track Adult

Keywords

COVID-19 myocarditis

non-ischemic cardiomyopathy

delayed presentation

left ventricular dysfunction

ejection fraction

troponin elevation

BNP

echocardiography

guideline-directed medical therapy

heart failure

COVID-19

Myocarditis

Heart Failure

Troponin

Cardiomyopathy