Presentations and Outcomes of Severe Cardiac Complications in COVID-19: Rhode Island Experience.

Forty-one (41) patients admitted to Rhode Island hospitals with COVID-19 from April to November 2020 were identified to have severe cardiac complications. Clinical presentations of cardiovascular system toxicity in COVID-19 included myocarditis, pericarditis, cardiomyopathy, ACS and cardiac arrhythmia. Clinical features, hospital outcomes and post-discharge outcomes were characterized. Acute myocarditis (46.3%) and cardiomyopathy (29.3%) were the most common findings followed by cardiac arrhythmia, acute coronary syndrome, and pericardial disease. Pulmonary involvement of COVID-19 was absent in 41.5% of patients. Comorbid cardiovascular conditions were absent in 29.3% of patients. Severe cardiac complications in COVID-19 were associated with an in-hospital mortality rate of 61%. Among survivors with COVID-19-related cardiomyopathy, only 20% demonstrated recovery of LV function on follow-up echocardiography done within 12 weeks after initial diagnosis. Identification, diagnosis and management of severe cardiac complications in COVID-19 are discussed.

Eosinophilic Myocarditis in a Patient With Sickle Cell Disease.

A 23-year-old man with sickle cell disease treated with splenectomy and allogenic stem cell transplantation presented with recurrent chest pain, elevated cardiac enzymes, and unremarkable electrocardiography. His work-up revealed eosinophilia, raising concern for eosinophilic myocarditis. Cardiac magnetic resonance imaging showed patchy late gadolinium enhancement of the left ventricular free wall, suggestive of myocarditis. He was treated with high-dose intravenous steroids followed by oral prednisone, with improvement in his symptoms and eosinophilia and a decrease in cardiac enhancement on follow-up imaging. (Level of Difficulty: Intermediate.).