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(2
): 154-7
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Identification of COVID-19-associated myocarditis by speckle-tracking
transesophageal echocardiography in critical care
#MMPMIDC7685046
Wehit JM
; Sosa FA
; Merlo P
; Roberti J
; Osatnik J
ä-/-ä 2022[Apr]; 22
(2
): 154-7
PMIDC7685046
show ga
A 68-year-old male presented with flu-like symptoms, fatigue, history of obesity,
hypertension, type 2 diabetes and chronic smoking. Chest radiography revealed
right basal opacity consisting of infiltrate. With respiratory failure,
orotracheal intubation and mechanical ventilation were performed. Patient
presented gas exchange alteration. Real-time PCR detected SARS-CoV-2. Treatment
with liponavir/ritonavir and hydroxychloroquine was started. Because of poor
acoustic window, speckle-tracking transoesophageal echocardiography (TEE) was
performed, detecting deterioration in global longitudinal strain. Acute COVID 19
infection led us to suspect myocarditis, with no other signs or symptoms other
than elevated troponin and altered strain. On day 15, the patient suffered
bacteraemic sepsis at endovascular focus with Serratia marcescens and multiorgan
failure. TEE-guided haemodynamic monitoring was repeated showing global
longitudinal strain improvement. Acute COVID 19 infection led us to suspect
myocarditis, with no other signs or symptoms beyond elevated troponin and altered
strain.