SHM Converge Scientific Abstract ePoster Gallery-Recognizing Non-Ischemic Cardiomyopathy as a Complication of Post Covid-19 Infection

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This case report describes a 63-year-old woman with hypertension who developed new-onset shortness of breath several weeks to months after recovering from COVID-19. Although she had initially been treated for COVID-19 with remdesivir, dexamethasone, and convalescent plasma, she later continued to test positive for about two months and gradually developed palpitations, fatigue, and worsening dyspnea. On presentation, she was tachycardic and hypertensive but maintained normal oxygen saturation. Examination also showed bilateral pedal edema.<br /><br />Initial workup included a CT angiogram of the chest, which was negative for pulmonary embolism but showed ground-glass opacities. Laboratory studies showed markedly elevated troponin and BNP. ECG revealed sinus tachycardia. Echocardiography demonstrated severe left ventricular systolic dysfunction with an ejection fraction of 20–24%. Left heart catheterization showed no coronary artery disease, supporting a diagnosis of non-ischemic cardiomyopathy. Right heart catheterization showed type I and type II pulmonary artery hypertension. A repeat echocardiogram three months later still showed an ejection fraction of 20%.<br /><br />The report emphasizes that while acute COVID-19 is known to cause myocarditis and cardiac injury, delayed development of cardiomyopathy after infection is uncommon. Possible mechanisms include direct viral myocardial injury through ACE2 receptors and indirect inflammatory damage, but the cause of delayed cardiac dysfunction remains unclear. The authors stress that non-ischemic cardiomyopathy should be considered in post-COVID patients with new shortness of breath, alongside more common causes such as pulmonary embolism and myocardial infarction, to avoid diagnostic delay and ensure prompt management.

Asset Subtitle

Santosh Yatam Ganesh

Meta Tag

Author List Nagakrishnal Nachimuthu, Santosh Yatam Ganesh

Category Clinical Vignettes

Concept Nonischemic Cardiomyopathy

Concept COVID-19 Infection

Concept Dyspnea

Concept Cardiac Evaluation

Concept Troponin

Distinguished Non-Finalist

Presenter Organization Chi St. Luke’s Livingston

Presenting Author Santosh Yatam Ganesh

Track Adult

Keywords

COVID-19

non-ischemic cardiomyopathy

shortness of breath

left ventricular dysfunction

ejection fraction

pulmonary hypertension

troponin elevation

BNP elevation

ground-glass opacities

myocardial injury

Nonischemic Cardiomyopathy

COVID-19 Infection

Dyspnea

Cardiac Evaluation

Troponin