https://doi.org/10.4081/monaldi.2021.1778

Acute heart failure due to COVID-19 related myocardial injury and de novo hypertensive cardiomyopathy: a challenging diagnosis

Vol. 92 No. 1 (2022)
Submitted: January 24, 2021
Accepted: July 28, 2021
Published: September 14, 2021
COVID-19, myocarditis, cardiac MRI, hypertensive cardiomyopathy, echocardiography
Abstract Views: 1201
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Supplementary: 69
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Authors

Matteo Pernigo
matteo.pernigo@gmail.com
Cardiology Unit, ‘La Memoria’ Hospital, Gavardo (BS) , Italy.
Marco Triggiani
Cardiology Unit, ‘La Memoria’ Hospital, Gavardo (BS), Italy.
Emanuele Gavazzi
Institute of Radiology, Department of Medical and Surgical Specialties, University of Brescia, Italy.
Ilaria Papa
https://orcid.org/0000-0003-3106-6419
Cardiology Unit, ‘La Memoria’ Hospital, Gavardo (BS), Italy.
Alberto Vaccari
Cardiology Unit, ‘La Memoria’ Hospital, Gavardo (BS), Italy.
Simona Fisogni
Institute of Anatomical Pathology, Department of Medical and Surgical Specialties, University of Brescia, Italy.
Ester Costantino
Nephrology Unit, ‘La Memoria’ Hospital, Gavardo (BS), Italy.
Gian Franco Pasini
Cardiology Unit, ‘La Memoria’ Hospital, Gavardo (BS), Italy.

We report a COVID-19 case with acute heart and kidney failure in a healthy young male. Echocardiography showed severe systolic and diastolic left ventricle dysfunction, with diffuse myocardial thickening. Cardiac MRI showed aspects of focal myocarditis, and hypertensive cardiomyopathy. Renal biopsy demonstrated limited acute tubular injury, and hypertensive kidney disease. Coronary angiography excluded critical stenoses. Unlike what we initially suspected, myocardial inflammation had a limited extent in our patient; severe hypertension causing cardiomyopathy and multi-organ damage, not diagnosed before, was primarily responsible for severe illness. Correct diagnosis and guidelines-directed treatment allowed a favorable course.

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How to Cite

Pernigo, Matteo, Marco Triggiani, Emanuele Gavazzi, Ilaria Papa, Alberto Vaccari, Simona Fisogni, Ester Costantino, and Gian Franco Pasini. 2021. “Acute Heart Failure Due to COVID-19 Related Myocardial Injury and De Novo Hypertensive Cardiomyopathy: A Challenging Diagnosis”. Monaldi Archives for Chest Disease 92 (1). https://doi.org/10.4081/monaldi.2021.1778.
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