A Case of Long COVID-19 Myocarditis with Asymptomatic Manifestation in a Young Male

Abstract

Background. Myocarditis is one of the most dangerous complications of both the acute phase of COVID-19 and long COVID-19, with a rather heterogeneous clinical presentation that ranges from asymptomatic to life-threatening. The diverse clinical presentation with a high risk of further complications, on the one hand, and a good prognosis in case of appropriate treatment, on the other hand, demand great attention from doctors. Case Report. We report a case of a 27-year-old male presented to a cardiologist with complaints of dyspnea, chest pain, palpitation occurred eight months after a mild COVID-19 episode. The diagnostic search commenced with a detailed questioning and physical examination with further laboratory testing and instrumental procedures, including resting electrocardiography, resting two-dimensional speckle-tracking echocardiography, and stress echocardiography. Gadolinium-enhanced cardiac magnetic resonance was the final step in diagnosis establishment. Half-a-year follow-up period of the patient with asymptomatic manifestation of COVID-19 myocarditis demonstrated the normalization of the condition after prescribed pathogenetic treatment. Conclusions. This case report raises awareness of the need for prolonged follow-up of patients after an episode of COVID-19 and proposes a comprehensive approach to a possible differential diagnostic search for precise diagnosis and treatment in a young male with rationale based on the relevant literature.

Keywords

• case report
• myocarditis
• long covid-19
• cardiovascular magnetic resonance
• speckle-tracking echocardiography
• stress echocardiography
• combination therapy