Atrioventricular block revealing myocarditis in a patient infected with SARS CoV-2 in Cotonou

ABSTRACT

Introduction: The cardiovascular impact of SARS CoV-2 infection in black subjects is poorly described in the literature. This article reports a case of myocardial injury during this viral infection. Case report A 63-year-old, hypertensive and diabetic woman whose symptomatology started with chest pain, was admitted in cardiogenic shock associated with severe bradycardia at 25 bpm due to complete atrioventricular block. Troponinemia was elevated at 33769.8 ng/mL and NT-proBNP greater than 25,000 pg/mL. Transthoracic echocardiography had shown abnormalities of left ventricular segmental kinetics with preserved ejection fraction and right ventricular dysfunction. The chest Computed Tomography (CT) scan diagnosed SARS CoV-2 infection by showing central and peripheral ground-glass opacity of the lungs. The SARS CoV-2 PCR test was negative twice. After a temporary transvenous cardiac pacing, heparin therapy, a combination of Ceftriaxone and antivirals, the evolution was marked by an initial clinical improvement followed by a secondary deterioration with aggravation of the biological inflammatory syndrome contrasting with the regression of atrioventricular block and myocardial injury. Death occurred on the 12th day of hospitalization.