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Cardiac Damage in an Adolescent Patient with COVID-19: a Case Report (a) Department of Internal Medicine, Faculty of Medicine, Jenderal Achmad Yani University Abstract COVID-19 has been found to affect the cardiovascular system leading to myocardial damage. As a chronic sequela, this condition may result in cardiomyopathy. We report a case of an adolescent COVID-19 survivor with dilated cardiomyopathy who had no underlying heart disease. A male patient aged 16 was admitted to our outpatient clinic with a primary symptom of exhaustion and had recently recovered from mild to moderate COVID-19 one month prior to the visit. The patient had no previous history of heart disease. Physical examination showed no abnormalities, but the laboratory results revealed substantially elevated NT-proBNP (7705 pg/mL) and D-dimer (1850 ng/mL). ECG showed normal sinus rhythm with poor R wave progression. Bedside echocardiography revealed all chamber dilatation, eccentric left ventricular hypertrophy, global hypokinetic, moderate mitral regurgitation and reduced ejection fraction (22%). We diagnosed the patient with new-onset dilated cardiomyopathy as a COVID-19 sequela, and we began treatment with an angiotensin II receptor blocker (candesartan), a beta-blocker (bisoprolol), diuretics (furosemide and spironolactone), rivaroxaban, and trimetazidine. The recovery was steady at a three-month follow-up visit. The emergence of new-onset cardiomyopathy in this previously healthy young patient raises the possibility of COVID-19 acting as a sole cause of myocardial injury in the absence of underlying heart disease. To avoid further complications, comprehensive evaluation and effective therapy should be implemented during hospitalization and post-discharge period. To offer final proof, additional tests such as cardiac magnetic resonance imaging and endomyocardial biopsies should be performed. Keywords: Cardiomyopathy, COVID-19, myocardial injury Topic: COVID-19 |
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