PMC7575039_01
Chest computed tomography. Axial (A, B and C) and sagittal (D) images of chest computer tomography performed during inpatient stay, showing several ground-glass opacities and consolidation foci in all pulmonary lobes, compatible with infectious disease, suggestive of COVID-19 in appropriate clinical environment
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The CT study revealed ( Figure 1 ) small round ground-glass opacities, with multifocal distribution on both lungs, more evident on the left peri-hilar region, which corroborated the possibility of COVID-19 among differential diagnoses.
Electrocardiogram within normal range of normality for age, sex, and biotype
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An electrocardiogram was then performed ( Figure 2 ), but did not show signs of ischemia, and the echocardiogram presented a reduction in the ejection fraction in relation to a previous study performed 7 months earlier (from 45% to 35%).
Cardiac magnet resonance imaging images on short axis. (A) and late myocardial enhancement sequences on the long axis of the four chambers (B) and short axis; (C and D) showing areas of late enhancement with non-ischemic pattern on the septal base wall of the left ventricle (arrows), findings that, in the clinical scenario, suggest inflammatory/infectious process (myocarditis)
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The CMR revealed the presence of late enhancement areas with an ischemic pattern on the left ventricle base septum wall, along with pronounced diffuse hypokinesia, and global systolic function involvement, confirming the presumptive diagnosis of myocarditis related to the new coronavirus ( Figure 3 ).