Microvascular thrombi in recurrent myocardial injury after coronavirus disease 2019 infection

Aikawa, Tadao; Ogino, Jiro; Hirofuji, Aina; Oyama‐Manabe, Noriko

doi:10.1093/eurheartj/ehab539

Cited by 2 publications

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“…Some acute myocarditis COVID-like syndrome cases were reported in 2020 [ 6 ]. COVID-19 infection has also been occasionally associated with Kawasaki-like vasculitis and systemic arterial and venous thromboembolism, as well as other vascular injuries [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiac MRI in patients with COVID-19 infection

et al. 2022

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Objective COVID-19 infection is a systemic disease with various cardiovascular symptoms and complications. Cardiac MRI with late gadolinium enhancement is the modality of choice for the assessment of myocardial involvement. T1 and T2 mapping can increase diagnostic accuracy and improve further management. Our study aimed to evaluate the different aspects of myocardial damage in cases of COVID-19 infection using cardiac MRI. Methods This descriptive retrospective study included 86 cases, with a history of COVID-19 infection confirmed by positive RT-PCR, who met the inclusion criteria. Patients had progressive chest pain or dyspnoea with a suspected underlying cardiac cause, either by an abnormal electrocardiogram or elevated troponin levels. Cardiac MRI was performed with late contrast-enhanced (LGE) imaging, followed by T1 and T2 mapping. Results Twenty-four patients have elevated hsTnT with a median hsTnT value of 133 ng/L (IQR: 102 to 159 ng/L); normal value < 14 ng/L. Other sixty-two patients showed elevated hsTnI with a median hsTnI value of 1637 ng/L (IQR: 1340 to 2540 ng/L); normal value < 40 ng/L. CMR showed 52 patients with acute myocarditis, 23 with Takotsubo cardiomyopathy, and 11 with myocardial infarction. Invasive coronary angiography was performed only in selected patients. Conclusion Different COVID-19-related cardiac injuries may cause similar clinical symptoms. Cardiac MRI is the modality of choice to differentiate between the different types of myocardial injury such as Takotsubo cardiomyopathy and infection-related cardiomyopathy or even acute coronary syndrome secondary to vasculitis or oxygen-demand mismatch. Key Points • It is essential to detect early COVID-related cardiac injury using different cardiac biomarkers and cardiac imaging, as it has a significant impact on patient management and outcome. • Cardiac MRI is the modality of choice to differentiate between the different aspects of COVID-related myocardial injury.

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Section: Introductionmentioning

confidence: 99%

Cardiac MRI in patients with COVID-19 infection

et al. 2022

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“…The phenomenon of thrombogenesis after COVID-19 recovery indicates anticoagulation may be necessary [83]. One review has indicated that the risk of thrombosis should be assessed for each patient as soon as possible, and anticoagulants should be provided when necessary [84] (Figure 3).…”

Section: Anticoagulation Agentsmentioning

confidence: 99%

Coronavirus Disease 2019, Myocardial Injury, and Myocarditis

Xiang

Zhang

et al. 2023

CVIA

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After its initial outbreak in 2019, the 2019 novel coronavirus disease (COVID-19) remains a global health concern. COVID-19 is well known for causing severe respiratory pathology, but it can also cause a variety of extra-pulmonary manifestations. Among them, myocardial injury has received substantial attention because it is usually associated with poor prognosis and mortality, thus emphasizing the importance of monitoring and managing myocardial injury in patients with COVID-19. Myocarditis has received attention as a complication of myocardial injury during and after the onset of COVID-19. Here, to aid in clinical decision-making, we present a narrative review on COVID-19- associated myocardial injury and myocarditis, discussing clinical evidence, pathogenesis, diagnostic tools, and therapeutic strategies.

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Microvascular thrombi in recurrent myocardial injury after coronavirus disease 2019 infection

Cited by 2 publications

References 0 publications

Cardiac MRI in patients with COVID-19 infection

Cardiac MRI in patients with COVID-19 infection

Coronavirus Disease 2019, Myocardial Injury, and Myocarditis

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