Fulminant myocarditis as an early presentation of SARS-CoV-2
Fulminant myocarditis as an early presentation of SARS-CoV-2
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DOI：
10.1136/bcr-2020-237553
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发表时间：
2020-09-01
期刊：
影响因子：
0.9
通讯作者：
Prasad, Neeraj
中科院分区：
文献类型：
--
作者：
Naneishvili, Tamara;Khalil, Arsalan;Prasad, Neeraj
众所周知，心肌炎是由病毒感染引起的，如科萨基病毒组B、人疱疹病毒6和细小病毒B19。然而，在目前新出现的SARS-CoV-2爆发期间，很少有病例报告将心肌炎描述为可能的表现。在我们的病例报告中，我们描述了在英国地区综合医院SARS-CoV-2的早期心脏表现。一名44岁的白人妇女，没有任何合并症，提出了与SARS-CoV-2相关的暴发性心肌炎，没有最初的呼吸道症状。患者接受米力农和甲基强的松龙治疗，显示心肌炎症减轻，心肌收缩力显著改善。随后是第二阶段的SARS-CoV-2相关肺炎和肾衰竭，需要辅助治疗和血液滤过。虽然没有在文献中描述，我们发现米力农和甲基强的松龙联合使用对SARS-CoV-2暴发性心肌炎患者有效。
Myocarditis is well known to be caused by viral infections such as Coxsackie virus group B, human herpes virus 6 and parvovirus B19. However, during the current emerging outbreak of SARS-CoV-2, there have been few case reports describing myocarditis as a possible presentation. In our case report we describe, early cardiac manifestations of SARS-CoV-2 in a UK District General Hospital. A 44-year-old Caucasian woman without any comorbidities presented with SARS-CoV-2 related fulminant myocarditis without initial respiratory symptoms. Patient underwent treatment with milrinone and methylprednisolone that showed reduction in myocardial inflammation and significantly improved myocardial contractility. This was then followed by a second phase of SARS-CoV-2 associated pneumonia and renal failure requiring ventilatory support and haemofiltration. Although, not described in the literature, we have found conjunctive use of milrinone and methylprednisolone effective in patient with SARS-CoV-2 fulminant myocarditis.