PT  - JOURNAL ARTICLE
AU  - Tamara Naneishvili
AU  - Arsalan Khalil
AU  - Ryan O'Leary
AU  - Neeraj Prasad
TI  - Fulminant myocarditis as an early presentation of SARS-CoV-2
AID  - 10.1136/bcr-2020-237553
DP  - 2020 Sep 01
TA  - BMJ Case Reports
PG  - e237553
VI  - 13
IP  - 9
4099  - http://casereports.bmj.com/content/13/9/e237553.short
4100  - http://casereports.bmj.com/content/13/9/e237553.full
SO  - BMJ Case Reports2020 Sep 01; 13
AB  - Myocarditis is well known to be caused by viral infections such as Coxsackie virus group B, human herpes virus 6 and parvovirus B19. However, during the current emerging outbreak of SARS-CoV-2, there have been few case reports describing myocarditis as a possible presentation. In our case report we describe, early cardiac manifestations of SARS-CoV-2 in a UK District General Hospital. A 44-year-old Caucasian woman without any comorbidities presented with SARS-CoV-2 related fulminant myocarditis without initial respiratory symptoms. Patient underwent treatment with milrinone and methylprednisolone that showed reduction in myocardial inflammation and significantly improved myocardial contractility. This was then followed by a second phase of SARS-CoV-2 associated pneumonia and renal failure requiring ventilatory support and haemofiltration. Although, not described in the literature, we have found conjunctive use of milrinone and methylprednisolone effective in patient with SARS-CoV-2 fulminant myocarditis.