A case report of management of cardiomyopathy in a patient with prior COVID infection

Cook Meghan I
2021 Journal of Surgery and Surgical Research  
The novel coronavirus (SARS-CoV-2) is responsible for the current pandemic and while most patients have mild symptoms, severe COVID-19 infections can have long-lasting symptoms. There is data to suggest that sequelae from COVID-19 persist for months. Viral myocarditis and cardiomyopathy related to COVID-19 have been described in the non-pregnant population. We present a case of a parturient presenting with left ventricular global hypokinesis and ejection fraction of 38% two months after initial
more » ... COVID-19 infection. Pregnant patients with COVID-19related cardiomyopathy should be managed by a multidisciplinary team. We suggest considering SARS-CoV-2 infection in parturients presenting with symptoms of decompensated heart failure. A 36-year-old G2 P0010 woman presented at 25 weeks 5 days gestation with dyspnea. Her medical history included gestational hypertension, hypothyroidism, mild asthma, type 2 diabetes, and morbid obesity (BMI 52.5kg/m 2 prepregnancy). She had known exposure to COVID-19 and a reverse transcription polymerase chain reaction test of a nasopharyngeal swab was positive. Her presenting symptoms were exertional dyspnea, fever (101.7°F), and hypoxia (requiring 2L oxygen via nasal cannula to maintain oxygen saturation >92%). Vital signs on admission included HR 121, BP 199/58, RR 25, temperature 98.7°F (37.1°C). Laboratory values included procalcitonin 0.06 ng/mL (normal <0.5 ng/mL), troponin <0.01 ng/mL (normal <0.11 ng/mL), C-Reactive Protein 161.55 mg/ dL (normal <100 mg/dL), hemoglobin 9.7 g/dL (normal 11.4 -15.2 g/dL), and D-dimer 1.21 mcg/mL (normal <0.50 mcg/mL), Brain Natriuretic Peptide (BNP). 8 pg/mL (median BNP levels remain less than 20 pg/ mL in normal pregnancy). Chest radiograph (CXR) revealed
doi:10.17352/2455-2968.000140 fatcat:eegoxkzvtjcd7oyf7wge6elfwi