Myocarditis Following COVID-19 Vaccination: A Systematic Review.

COVID-19 vaccination has significantly reduced both the morbidity and mortality rates associated with SARS-CoV-2 infection. Vaccines, especially mRNA vaccines, have been proposed in several studies to complicate viral myocarditis. Thus, our systematic and meta-analysis review aims to further investigate the possibility of an association between COVID-19 vaccines and myocarditis. We systematically searched PubMed, Web of Science, Scopus, Ovid, and Google Scholar and did a gray search of other databases using the following keywords and terms: "Myocarditis ("Myocarditis" Mesh) OR "Chagas Cardiomyopathy" Mesh) AND "COVID-19 Vaccines" Mesh. The studies were limited to only English articles that reported myocardial inflammation or myocarditis associated with COVID-19 vaccines. Pooled risk ratio with its 95% confidence interval was analyzed by RevMan software (5.4) to perform the meta-analysis. Our study included 671 patients from 44 studies with a mean age of 14-40 years. Nevertheless, myocarditis was noted in a mean of (3.227) days, and 4.19 per million vaccination recipients experienced myocarditis. Most cases were clinically presented with manifestations of cough, chest pain, and fever. Laboratory tests revealed increased C-reactive protein, and troponin with all other cardiac markers in most patients. Cardiac magnetic resonance imaging (MRI) revealed late gadolinium enhancement with myocardial edema and cardiomegaly. Also, electrocardiograms revealed ST-segment elevation in most patients. Furthermore, the incidence of myocarditis was statistically significantly lower in the COVID-19 vaccine group as compared with the control group (RR = 0.15, 95% CI = 0.10-0.23, p-value < 0.00001). No significant association was found between COVID-19 vaccines and the incidence of myocarditis. The study's findings highlight the importance of implementing evidence-based COVID-19 prevention strategies, such as vaccination, to reduce the public health impact of COVID-19 and its associated complications.

Acute symptomatic COVID-19 myocarditis: Case series

Background Coronavirus disease 2019 COVID-19 still remains a major cause of morbidity and mortality worldwide, mainly due to Acute Respiratory Distress Syndrome (ARDS). Nevertheless, other extra-pulmonary pathological aspects of COVID-19, notably cardiovascular, were disclosed as the global understanding of the pathogen agent advanced. Objectives To detect and evaluate acute myocarditis in patients with active and symptomatic COVID-19 infection. Materials and methods In this prospective analysis, patients presented with active COVID-19 illness and meeting the inclusion criteria were identified at the University Hospital Complex of Rabat between January and September 2021. Results Fifteen patients (8 males and 7 females) aged from 17 to 52 were included during the analysis period, the average delay between the confirmation of COVID-19 and the onset of myocarditis symptomatology was 17 days. The symptomatology was dominated by chest pain, unexplained cardiogenic shock and palpitations. The ECG showed essentially diffuse repolarization disorders. The inflammatory markers were significantly disturbed with an elevation of ultra-sensitive cardiac troponin I in all patients. Cardiac MRI showed impaired global longitudinal strain (GLS) myocardial edema, early and late subepicardial Gadolinium enhancement, compared to the control group (p < 0,01). Conclusion Cardiac involvement was detected in a proportion of patients with active COVID-19. Age, gender, clinical and electrical presentations didn't seem to influence the diagnosis. Cardiac MRI played an essential role for detecting and evaluating active myocarditis. Patients who presented myocardial injury had to have a longer follow-up as current understanding of long-term prognosis is still lacking.

Cardiac MRI in Suspected Acute COVID-19 Myocarditis.

Keywords: COVID-19; coronavirus; myocarditis; cardiac MRI; T1 mapping; T2 mapping.

A case series of desmoplakin cardiomyopathy: a mimic of viral myocarditis.

Background: Clinical features and imaging presentation of myocarditis can overlap with other inflammatory or arrhythmogenic cardiomyopathies. Desmoplakin (DSP) is an important structural cardiac protein. Mutations in the DSP gene are associated with a variant of arrhythmogenic right ventricular cardiomyopathy (ARVC). Interestingly, this distinct genetic cardiomyopathy can also present with a myocardial inflammation and fibrosis pattern that may mimic other forms of myocarditis including viral myocarditis, which can raise a clinical challenge. We report two cases of DSP cardiomyopathy, which were initially thought to represent coronavirus disease of 2019 (COVID-19) myocarditis. Case summary: First patient is a 21-your-old woman with no past medical history but family history of presumed 'viral myocarditis' and ventricular tachycardia in her brother. She presented with acute chest pain and elevated cardiac enzymes. She tested positive for COVID-19 and given the suspicion for possible COVID-19 related acute myocarditis, cardiac magnetic resonance imaging obtained and revealed regional wall motion abnormalities, several areas of subepicardial and pericardial late gadolinium enhancement (LGE). Ambulatory cardiac monitoring showed runs of non-sustained ventricular tachycardia and considering her family history of arrhythmogenic myocarditis, genetic testing was performed that was positive for a likely pathogenic heterozygous mutation of DSP gene. She declined the recommended implantable cardioverter defibrillator (ICD).Second patient is a 34-year-old physician with no significant past medical history who works at a COVID-19 unit and presented with syncope and was found to have ventricular tachycardia. Echocardiogram revealed severely dilated left ventricle and globally depressed systolic function with left ventricular ejection fraction of 20%. Coronary computed tomography angiography showed no evidence of coronary atherosclerosis. Cardiac magnetic resonance imaging revealed several areas of mid myocardial and pericardial LGE. Subcutaneous ICD was implanted and an endomyocardial biopsy had evidence of lymphocytic myocarditis and adipose tissue infiltration of the myocardium. Genetic testing revealed pathogenic heterozygous DSP mutation. He underwent epicardial ablation for the episodes of ventricular tachycardia despite medical therapy. He was able to return to work and has not had any further episodes of arrhythmia. Conclusion: Mutations in the DSP gene are associated with left dominant arrhythmogenic cardiomyopathy, which is a variant of ARVC. Beside left ventricular systolic dysfunction and ventricular tachyarrhythmias, carriers of these mutations may present with episodes of chest pain associated with elevated cardiac enzymes and cardiac imaging findings indistinguishable from other forms of acute myocarditis including viral myocarditis. Currently, there are no guidelines for diagnosis and treatment of this entity.

COVID-19 Infections in Adults with Congenital Heart Disease-A Prospective Single-Center Study in an Outpatient Setting.

BACKGROUND: COVID-19 might pose a risk for adults with congenital heart disease (ACHD). However, data regarding the rate of infection as well as myocardial involvement in ACHD patients are currently lacking. METHODS: During the study period from January to June 2021, all consecutive outpatients from our ACHD clinic were eligible to participate. Clinical data were collected. An antibody test for COVID-19 was performed in all patients. Cardiovascular magnetic resonance imaging (CMR) was offered to those with a positive antibody test. RESULTS: Overall, 420 patients (44.8% female, mean age 36.4 ± 11.6 years) participated. Congenital heart defect (CHD) complexity was simple in 96 (22.9%), moderate in 186 (44.3%), complex in 117 (27.9%), and miscellaneous in 21 (5.0%) patients. Altogether, 28 (6.7%) patients had a positive antibody test. Out of these, 14 had an asymptomatic course. The others had mainly mild symptoms and were managed as outpatients. Furthermore, 11 patients (39.3%) had even not been aware of their infection. Fourteen patients underwent a CMR without signs of myocardial involvement in any of them. CONCLUSIONS: We observed a number of undetected cases of COVID-19 infections in our ACHD population. Reassuringly, in all cases, the infection had a mild clinical course.

Possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation

Computed and magnetic resonance imaging of the heart has been widely used in recent years in patients with atrial fibrillation. They are used to determine the morphology of the heart, the presence of intracardiac thrombi, quantify the structures of the heart, thrombosis of intracardiac devices, determine tactics for surgical interventions, and other purposes. These methods of instrumental diagnostics can be used as an alternative to transesophageal echocardiography, which has a number of limitations and disadvantages compared to computed tomography and magnetic resonance imaging. Computed and magnetic resonance imaging of the heart are used to avoid invasiveness in the study of the heart, to improve the accuracy of measuring heart structures, to reduce the number of diagnostic methods used before various surgical interventions in patients with atrial fibrillation, and also, according to epidemic indications, as part of the prevention of the spread of coronavirus infection. In addition, magnetic resonance imaging allows to avoid radiation exposure to the patient. The review presents the results of studies, meta-analyses of pooled samples, as well as a description of the clinical possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation. Publications on the use of these methods for visualization of thrombi in the left atrium and its appendage, in pulmonary vein ablation and occlusion of the left atrial appendage, as well as data on visualization of the residual flow around the occlusive device and thrombosis of intracardiac devices are presented. According to the results of a literature review, computed tomography and magnetic resonance imaging of the heart have similar or higher imaging capabilities compared to transesophageal echocardiography, as well as some advantages over it, primarily the non-invasiveness of the procedure. The works demonstrating the possibilities of computed tomography of the heart for the diagnosis of coronary heart disease in patients with atrial fibrillation are presented. In preparing the review, the literature search method in PubMed databases for the period 2013–2022 was used. © Eco-Vector, 2023. All rights reserved.

Myocardial Inflammation on FDG PET/MRI and Clinical Outcomes in Symptomatic and Asymptomatic Participants after COVID-19 Vaccination.

Purpose: To evaluate potential cardiac sequelae of COVID-19 vaccination at 2-month follow-up and relate cardiac symptoms to myocardial tissue changes on fluorodeoxyglucose (FDG) PET/MRI, blood biomarkers, health-related quality of life, and adverse outcomes. Materials and Methods: In this prospective study (ClinicalTrials.gov: NCT04967807), a convenience sample of individuals aged ≥17 years were enrolled after COVID-19 vaccination and were categorized as symptomatic myocarditis (new cardiac symptoms within 14 days of vaccination and met diagnostic criteria for acute myocarditis), symptomatic no myocarditis (new cardiac symptoms but did not meet criteria for myocarditis), and asymptomatic (no new cardiac symptoms). Standardized evaluation was performed 2 months after vaccination, including cardiac fluorine 18 FDG PET/MRI, blood biomarkers, and health-related quality of life. Statistical analysis included Kruskal-Wallis and Fisher exact tests. Results: Fifty-four participants were evaluated a median of 72 days (IQR: 42, 91) after COVID-19 vaccination, 17 symptomatic with myocarditis (36±[SD]15 years, 13 males), 17 symptomatic without myocarditis (42±12 years, 7 males), and 20 asymptomatic (45±14 years, 9 males). No participants in the symptomatic without myocarditis or asymptomatic groups had focal FDG-uptake, myocardial edema or impaired ventricular function. Two participants with symptomatic myocarditis had focal FDG-uptake, and three had high T2 on MRI. Health-related quality of life was lower in the symptomatic myocarditis group than the asymptomatic group. There were no adverse cardiac events beyond myocarditis in any participant. Conclusions: At two-month follow-up, FDG PET/MRI showed evidence of myocardial inflammation in 2/17 participants diagnosed with acute myocarditis early after COVID-19 vaccination, but not in symptomatic and asymptomatic participants without acute myocarditis.Keywords: Myocarditis, Vaccination, COVID-19, PET/MRI, Cardiac MRI, FDG-PET.

Myocarditis Following COVID-19 Vaccination.

Myocarditis is an established but rare adverse event following administration of messenger RNA-based coronavirus disease 2019 (COVID-19) vaccines and is most common in male adolescents and young adults. Symptoms typically develop within a few days of vaccine administration. Most patients have mild abnormalities on cardiac imaging with rapid clinical improvement with standard treatment. However, longer term follow-up is needed to determine whether imaging abnormalities persist, to evaluate for adverse outcomes, and to understand the risk associated with subsequent vaccination. The purpose of the review is to evaluate the current literature related to myocarditis following COVID-19 vaccination, including the incidence, risk factors, clinical course, imaging findings, and proposed pathophysiologic mechanisms.

Cardiac Assessment in Children with MIS-C: Late Magnetic Resonance Imaging Features.

Multisystem Inflammatory Syndrome (MIS-C) is a new entity that emerges 2-4 weeks after the SARS-CoV-2 infection in children. MIS-C can affect all systems, the most severe of which is cardiac involvement. The duration of the cardiac symptoms is still uncertain and may be persistent or prolonged. The American College of Rheumatology Clinical Guidelines recommends cardiac magnetic resonance imaging (MRI) 2-6 months after the diagnosis of MIS-C in patients presenting with significant transient left ventricular (LV) dysfunction in the acute phase of illness (LV ejection fraction 50%) or persistent LV dysfunction. There are a few studies investigating cardiac MRI findings in MIS-C patients. In this study, we aimed to evaluate cardiac MRI findings, at the earliest 3 months after diagnosis, and compare these findings with the echocardiograms in children with MIS-C. A retrospective study including 34 MIS-C patients was conducted at a tertiary-level University Hospital between June 2020 and July 2021. Centers for Disease Control and Prevention criteria were used in the diagnosis of MIS-C. Cardiac MRI was performed at least 3 months after MIS-C diagnosis. The study included 17 (50%) boys and 17 (50%) girls with a mean age of 9.31 ± 4.72 years. Initial echocardiographic evaluation revealed cardiac abnormality in 13 (38.2) patients; 4 (11.8%) pericardial effusion, 4 (11.8%) left ventricular ejection fraction (LVEF) < 55%, and 5 (14.7%) coronary artery dilatation. Echocardiography showed normal LV systolic function in all patients during follow-up; coronary dilatation persisted in 2 of 5 (40%) patients at the 6th-month visit. Cardiac MRI was performed in 31 (91.2%) patients, and myocardial hyperemia was not detected in any patients (T1 relaxation time was < 1044 ms in all children). However, 9 (29%) patients' MRI showed isolated elevated T2 levels, and 19 (61.3%) revealed at least one of the following findings: pericardial effusion, right ventricular dysfunction, or LVEF abnormality. In patients with MIS-C, a high rate of cardiac involvement, particularly pericardial effusion was determined by cardiac MRI performed at the earliest 2-6 months after diagnosis. Even if echocardiography does not reveal any abnormality in the initial phase, cardiac MRI should be suggested in MIS-C patients in the late period. This is the first study reporting cardiac MRI findings in the late period of MIS-C patients.

A Systematic Review of COVID-19 and Myocarditis.

BACKGROUND: The COVID-19 infection which emerged in December 2019, is caused by the virus SARS-CoV-2. Infection with this virus can lead to severe respiratory illness, however, myocarditis has also been reported. The purpose of this study is to identify the clinical features of myocarditis in COVID-19 patients. METHODS: A systematic review was conducted to investigate characteristics of myocarditis in patients infected with COVID-19 using the search term "Coronavirus" or "COVID" and "myocarditis," "heart," or "retrospective." Case reports and retrospective studies were gathered by searching Medline/Pubmed, Google Scholar, CINAHL, Cochrane CENTRAL, and Web of Science databases. 11 articles were selected for review. RESULTS: COVID-19 myocarditis affected patients over the age of 50 and incidences among both genders were equally reported. Patients presented with dyspnea, cough, fever with hypotension and chest pain. Laboratory tests revealed leukocytosis with increased C-reactive protein, while arterial blood gas analysis demonstrated respiratory acidosis. All cardiac markers were elevated. Radiographic imaging of the chest showed bilateral ground glass opacities or bilateral infiltrates, while cardiac magnetic resonance imaging produced late gadolinium enhancements. Electrocardiography demonstrated ST-segment elevation or inverted T waves, while echocardiography revealed reduced left ventricular ejection fraction with cardiomegaly or increased wall thickness. Management with corticosteroids was favored in most cases, followed by antiviral medication. The majority of studies reported either recovery or no further clinical deterioration. CONCLUSION: Current available data on COVID-19 myocarditis is limited. Further research is needed to advance our understanding of COVID-19 myocarditis.

Subclinical cardiac involvement in student athletes after COVID-19 infection - Evaluation using feature tracking cardiac MRI strain analysis.

OBJECTIVES: To evaluate subclinical cardiac dysfunction in student athletes after COVID-19 infection using feature tracking cardiac MRI strain analysis. METHODS: Student athletes with history of COVID-19 infection underwent cardiac MRI as part of screening before return to competitive play. Subjects were enrolled if they had no or mild symptoms, normal cardiac MRI findings with no imaging evidence of myocarditis. Feature tracking strain analysis was performed using short and long axis cine MRI images of athletes and a separate cohort of healthy controls. Differences between the cardiac strain parameters were statistically analyzed by Mann-Whitney U test. RESULTS: The study cohort included 122 athletes (49 females, mean age 20 years ± 1.5 standard deviations) who had a history of COVID-19, and 35 healthy controls (24 females, mean age 34 years ± 18 standard deviations). COVID-19 positive athletes had normal physiologic cardiac adaptations, including significantly higher left and right ventricle end-diastolic volumes (p = 0.00001) when compared to healthy controls. There was no significant difference between biventricular ejection fraction between athletes and control subjects (p > 0.05). Cardiac MRI parameters, including left ventricle global longitudinal strain (LV-GLS), global circumferential strain (LV-GCS), and global radial strain (LV-GRS) values were normal but slightly lower in athletes compared to controls. LV-GCS and LV-GRS were significantly lower in athletes compared to controls (p = 0.007 and p = 0.005 respectively), but there was no significant difference for LV-GLS (p = 0.088). CONCLUSION: In this study of 122 athletes, there was no evidence of subclinical myocardial alterations following recovery from COVID-19 found on cardiac MRI strain analysis. When compared to healthy controls, the competitive athletes had higher end-diastolic volume indices and reduced, albeit normal, strain values of LV-GLS, LV-GCS, and LV-GRS.

Cardiac MRI in midterm follow-up of MISC: a multicenter study.

In this multicenter retrospective study we aimed to evaluate the outcome of cardiac involvement in children affected by multisystem inflammatory syndrome (MIS-C), assessed through cardiac magnetic resonance (CMR). Children referring to three Italian tertiary pediatric centers between February 2020 and November 2021 with a diagnosis of MIS-C, who underwent CMR during a follow-up visit, were enrolled. Demographic, clinical, laboratory, treatment, and outcome data were collected. Twenty MIS-C patients (aged 9-17, median 12 years) were included in the study. Heart involvement at onset was testified by hypotension/shock (55%), laboratory evidence of myocardial involvement (100%), reduced LV ejection fraction (EF) on echocardiography (83%), and/or need for inotrope agents (40%); they all presented good clinical, laboratory, and echocardiographic response to treatment. CMR was performed after a median interval of 3 months from discharge. Pericardial effusion and myocardial edema were found in 5% of patients. Mild residual left ventricular (LV) dysfunction was found in 20% of patients, all showing normal echocardiographic LVEF at discharge. Minimal myocardial scars were found in 25% by late gadolinium enhancement (LGE). One patient was evaluated at two consecutive time points, showing partial resolution of a myocardial scar after 7 months from its first finding. CONCLUSION: Despite the severity of heart involvement in the acute MIS-C phase, the mid-term cardiac outcome is good. Direct cardiac tissue viral invasion may be involved in MIS-C pathogenesis. WHAT IS KNOWN: • Heart involvement is common in MIS-C, but conflicting findings have been shown regarding cardiac outcome when assessed through cardiac MRI. WHAT IS NEW: • Midterm cardiac MRI shows mild abnormalities in patients recovered from MIS-C with any grade of severity of cardiac involvement at presentation.

Cardiac manifestations of multisystem inflammatory syndrome in children

Background and Aim: We aimed to evaluate cardiac manifestations of the multisystem inflammatory syndrome in children(MIS-C) and the changes in cardiac function during one year of follow-up. Method(s): All children diagnosed as MIS-C with cardiac involve-ment were enrolled in this prospective study. The diagnosis and severity of the disease of MIS-C was made according to the Centers for Disease Control and World Health Organization guidelines. Clinical findings, laboratory parameters including car-diac markers, electrocardiographic and echocardiographic findings at the time of diagnosis and during follow-up were evaluated. Cardiac magnetic resonance imaging (MRI) was performed on all children with echocardiographic abnormality. Result(s): Between April 1st 2020 and December 1st 2021,71 chil-dren were diagnosed with MIS-C and 44 of these patients had car-diac involvement (25 male and 19 female). 24 patients were followed up in the intensive care unit and all of these patients had myocardial involvement. All the patients had elevated NT-proBNP levels (median:5893pg/ml) whereas troponin-T levels were above upper limit in 13 patients. A significant positive cor-relation was found between troponin-T and NT-proBNP (plt;0.01). The NT-proBNP levels were also positively correlated with the severity of MIS-C (plt;0.05). On admission 22 patients had tachycardia and atrioventricular conduction disturbances and supraventricular tachycardia developed in 5 of these patients during follow-up. Bradycardia was observed in 18(40%) patients during hospitalization (4 of these occurred after tachycardia). Although 26 patients had an echocardiographic abnormality, only twelve patients had systolic dysfunction (9 with mild and 3 with moderate) and two patients had diastolic dysfunction. NT-proBNP and troponin-T were negatively correlated with ejection fraction ve fractional shortening (respectively, p = 0.003, p = 0.013). Cardiac MRI was normal in all patients except 3 patients who had myocardial late gadolinium enhancement of left ven-tricle. Pericardial effusion was observed in 14 patients. The echo-cardiographic abnormalities disappeared in 42 patients during follow-up, one patient died on the second day of hospitalization and and 1 patient has ongoing LV systolic dysfunction. Conclusion(s): Bradycardia and myocardial involvement is common during MIS-C. Although myocardial dysfunction can be observed during acute disease, commonly the disease does not cause perma-nent damage during one year of follow-up.

Cardiac MRI Findings in COVID-19 Vaccine-Related Myocarditis: A Pooled Analysis of 468 Patients.

Understanding the pattern and severity of myocarditis caused by the coronavirus disease 2019 (COVID-19) vaccine is imperative for improving the care of the patients, and cardiac evaluation by MRI plays a key role in this regard. Our systematic review and meta-analysis aimed to summarize cardiac MRI findings in COVID-19 vaccine-related myocarditis. We performed a comprehensive systematic review of literature in PubMed, Scopus, and Google Scholar databases using key terms covering COVID-19 vaccine, myocarditis, and cardiac MRI. Individual-level patient data (IPD) and aggregated-level data (AD) studies were pooled through a two-stage analysis method. For this purpose, all IPD were first gathered into a single data set and reduced to AD, and then this AD (from IPD studies) was pooled with existing AD (from the AD studies) using fixed/random effect models. I² was used to assess the degree of heterogeneity, and the prespecified level of statistical significance (P value for heterogeneity) was <0.1. Based on meta-analysis of 102 studies (n = 468 patients), 79% (95% confidence interval [CI]: 54%-97%) of patients fulfilled Lake Louise criteria (LLC) for diagnosis of myocarditis. Cardiac MRI abnormalities included elevated T2 in 72% (95% CI: 50%-90%), myocardial late gadolinium enhancement (LGE) in 93% (95% CI: 83%-99%; nearly all with a subepicardial and/or midwall pattern), impaired left ventricular ejection fraction (LVEF) (<50%) in 4% (95% CI: 1.0%-9.0%). Moreover, elevated T1 and extracellular volume fraction (ECV) (>30), reported only by some IPD studies, were detected in 74.5% (76/102) and 32% (16/50) of patients, respectively. In conclusion, our findings may suggest that over two-thirds of patients with clinically suspected myocarditis following COVID-19 vaccination meet the LLC. COVID-19 vaccine-associated myocarditis may show a similar pattern compared to other acute myocarditis entities. Notably, preserved LVEF is probably a common finding in these patients. EVIDENCE LEVEL: 4 TECHNICAL EFFICACY: Stage 3.

SARS-CoV-2-related Multisystem Inflammatory Syndrome in Adult complicated by myocarditis and cardiogenic shock.

Multisystem Inflammatory Syndrome in Adult (MIS-A) is a rare COVID-19 complication, presenting as fever with laboratory evidence of inflammation, severe illness requiring hospitalization and multisystem organ involvement. We report on a 25-year-old man presenting with fever, rash, abdominal pain, diarrhoea and vomiting following prior asymptomatic COVID-19 infection. He developed refractory shock and type 1 respiratory insufficiency requiring mechanical ventilation. Diagnostic testing revealed significant inflammation, anemia, thrombocytopenia, acute kidney injury, hepatosplenomegaly, colitis, lymphadenopathy and myocarditis necessitating inotropy. Ventilatory, vasopressor and inotropic support was weaned following pulse corticosteroids and intravenous immunoglobulins. Heart failure therapy was started. Short-term follow-up shows resolution of inflammation and cardiac dysfunction.

Magnetic resonance syndromes of myocardial damage in patients after new coronavirus infection (COVID-19) - two typical clinical cases

Clinical examples for variants of cardiovascular complications of a new coronavirus infection (COVID-19) are presented when they are visualized by means of magnetic resonance imaging (MRI) of the heart and chest organs with paramagnetic contrast enhancement and synchronization with ECG and respiration signal. The syndromes of post-COVID focal infarct injury and diffuse inflammatory lesion are identified. The picture of MRI visualization of coronary atherosclerotic plaque is presented. The results of quantitative processing of cardiac MRI in these two different syndromes of post-COVID cardiological complications are presented. The presented clinical examples indicate the need for cardiac MRI to monitor patients and assess the long-term cardiovascular effects of COVID-19. © 2022 Folia Medica. All rights reserved.