Case Study on COVID-19-Induced Myocarditis in a Young Adult

Abstract

COVID-19 with the SARS-CoV-2 virus has mainly been described as a respiratory disease. Nonetheless, recent research shows that it might be dangerous for heart health, even leading to myocarditis, which is inflammation of the heart muscles. The above case is of a 27-year-old male patient who had a mild COVID-19 infection and later experienced acute myocarditis. We describe a patient's progress, investigation, treatment, and outcome. This case adds to the growing body of literature on the potential cardiac complications of COVID-19.

Introduction

Comparatively, the preliminary literature has given much attention to the respiratory manifestations of COVID-19. But as the COVID-19 virus continued to evolve, it was realized that the virus impacted different systems of the body such as the cardiovascular system. Another of the complications is myocarditis, which is commonly referred to as the inflammation of heart muscle. As for the symptoms, myocarditis is less often reported but cases of this complication following COVID-19 have been rapidly emerging. This specific case involves a 27-year-old male patient who had a released mild COVID and developed myocarditis due to COVID-19 infection. The relevance of this report is to create awareness and to urge people and healthcare professionals to not ignore cardiovascular conditions and symptoms, particularly in mild Coronavirus cases.

Patient Information

Patient Name: Maruti Patil.

Age: 27.

Sex: Male.

Medical History: The patient had no significant medical history. He did not smoke or consume alcohol, had no known allergies, and was not on any regular medication.

COVID-19 Diagnosis: The patient had tested positive for COVID-19 two weeks before presenting with cardiac symptoms. He experienced mild respiratory symptoms, including a low-grade fever, cough, and fatigue, but did not require hospitalization.

Clinical Finding

• Chief Complaint: The patient presented to the emergency department with chest pain, shortness of breath, and palpitations that began a week after recovering from COVID-19.
• Physical Examination: Upon examination, the patient was alert and oriented. His vital signs were as follows:

1. Temperature: 36.7°C
2. Heart rate: 115 beats per minute (tachycardia)
3. Blood pressure: 125/80 mmHg
4. Respiratory rate: 22 breaths per minute
5. Oxygen saturation: 98% on room air

An inflammation of the pericardium, known as pericarditis, was indicated by the deep, painful feeling in the chest that intensified with deep breathing or when lying flat. There were no indications of heart problems, such as leg swelling or sounds in the lungs.

Procedure

This case relates to a 27-year-old man who developed myocarditis after a recovery from mild COVID-19. Initially, he felt chest pain, palpitations, and shortness of breath, which urged him to get medical help. When examined, his electrocardiogram (ECG) revealed diffuse ST-segment elevation, and an increase in blood troponin levels illustrated heart muscle damage. Based on the results of an echocardiogram, it was found that heart function was mildly reduced. The patient was admitted, and provided with anti-inflammatory medicine and beta-blockers, and their condition gradually improved. After the check-up, his heart function returned to normal, and he was entirely recovered.

Timeline

• Day 1: Patient tests positive for COVID-19, and experiences mild symptoms.
• Day 14: Patient recovers from COVID-19 but begins experiencing chest pain and palpitations.
• Day 17: Patient presents to the emergency department with chest pain, palpitations, and shortness of breath

Diagnostic Assessment

• Electrocardiogram (ECG): The patient’s ECG showed diffuse ST-segment elevation, which is a hallmark sign of pericarditis.
• Cardiac Markers: Blood tests revealed elevated troponin levels (indicative of heart muscle injury), which suggested myocarditis.
• Echocardiogram: The echocardiogram showed a mildly reduced left ventricular ejection fraction (LVEF) of 45% (normal range is 55-70%), consistent with inflammation of the heart muscle.
• Cardiac MRI: The cardiac MRI confirmed myocarditis, showing areas of inflammation and edema in the heart muscle.
• COVID-19 Test: The patient tested negative for active COVID-19 infection at the time of presentation but had detectable antibodies, confirming previous infection.

Management Plan

The management of myocarditis, particularly following COVID-19, involves reducing inflammation and supporting heart function. Anti-inflammatory medications like NSAIDs are commonly used to control inflammation and relieve symptoms. For patients with heart failure or reduced heart function, medications such as beta-blockers, and ACE inhibitors are prescribed to improve heart performance. Rest and limiting physical activity are essential to reduce heart strain during recovery. In severe cases, especially where autoimmune involvement is suspected, immunosuppressive therapy may be considered. Close monitoring and follow-up are important to ensure recovery and prevent complications.

Follow-Up and Outcomes

The patient was admitted to the hospital for close monitoring. The patient was received by the hospital for close observation. He started taking non-steroidal anti-inflammatory drugs (NSAIDs) for the aim of reducing pain and inflammation, alongside beta-blockers to help control his heart rate. His symptoms were becoming less severe, as his cardiac function normalized in a few weeks.

• Day 30: The patient was discharged with instructions to avoid strenuous physical activity and follow up with his cardiologist.
• Day 60: On follow-up, the patient’s symptoms had fully resolved, and repeat echocardiography showed normal cardiac function with an LVEF of 60% (Normal: 55-70%).
• Long-Term Outlook: No further cardiac issues were reported, and the patient resumed his normal activities without complications.

Discussion

Research shows that COVID-19 can affect the cardiovascular system of even young, healthy individuals. Myocarditis can present from light inflammation to serious episodes that may result in heart failure or even sudden death. The method by which COVID-19 precipitates myocarditis is an ongoing subject of research, but it is believed to be connected to the body's reaction to the virus. In this case, myocarditis was developed by the patient soon following the recovery from a mild respiratory infection. His symptoms were only moderate in intensity, and his illness improved following the usual treatment protocol. This case points to the requirement for healthcare providers to be aware of the possible cardiac complications in patients with COVID-19, even when they initially show mild symptoms.

Takeaway

• COVID-19 can cause myocarditis, even in young, healthy individuals with mild initial symptoms.
• Healthcare providers should be vigilant in screening for cardiac symptoms in patients recovering from COVID-19.
• Early diagnosis and management of myocarditis can lead to positive outcomes, as seen in this case.

Patient Perspective

According to the patient, he realized that COVID-19 not only affects on respiratory tract but also damages other body parts or organ systems. He noted that the chest pain and shortness of breath were alarming, especially given his otherwise good health. He found himself feeling better after the treatment and he was comforted by the changes in his health. He liked the thorough follow-up and thought that the incremental directions for returning to his usual way of life were helpful.

Maruti Patil: “I didn’t think COVID could affect my heart since I only had a mild infection. It was a shock to feel chest pain and have trouble breathing even after I was supposed to be better. The care I got was excellent, and I’m glad I made a full recovery. It’s made me more aware of how serious COVID can be, even for someone young like me."

Conclusion

This case study demonstrates the need to identify the cardiac side effects of COVID-19 in young adults, since their symptoms may not be primarily respiratory. We should keep an eye on myocarditis as a complication in our study of the expanded consequences of COVID-19. Healthcare experts must keep a diligent eye out for the association of chest pain with myocarditis after a COVID-19 infection, which helps speed up necessary interventions that may preclude long-term heart damage.

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