Microthrombosis as a cause of fulminant myocarditis-like presentation with COVID-19 proven by endomyocardial biopsy

Satoshi Nakatani; Keiko Ohta-Ogo; Mayu Nishio; Kisaki Amemiya; Shuho Sato; Hirotaka Sawano; Kinta Hatakeyama; Harutaka Katano; Tadaki Suzuki; Keiji Hirooka

doi:10.1016/j.carpath.2022.107435

Microthrombosis as a cause of fulminant myocarditis-like presentation with COVID-19 proven by endomyocardial biopsy

Cardiovasc Pathol. 2022 Sep-Oct:60:107435. doi: 10.1016/j.carpath.2022.107435. Epub 2022 May 16.

Authors

Affiliations

¹ Department of Cardiology, Saiseikai Senri Hospital, Suita, Osaka, Japan. Electronic address: snakatani@senri.saiseikai.or.jp.
² Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
³ Department of Cardiology, Saiseikai Senri Hospital, Suita, Osaka, Japan.
⁴ Senri Critical Care Medical Center, Saiseikai Senri Hospital, Tsukumodai, Suita, Osaka, Japan.
⁵ Department of Pathology, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan.

Abstract

Myocardial injury has been reported as a complication of COVID-19. Although several mechanisms have been proposed as its cause, they are mostly based on autopsy studies, We report a 49-year-old male with COVID-19-associated myocardial injury presented like fulminant myocarditis. We performed endomyocardial biopsy on day 2 and we confirmed the presence of microthrombosis histologically. He died on day 5 due to cardiogenic shock.

Keywords: Biopsy; Cardiogenic shock; Cytokine storm; SARS-CoV-2.

Publication types

Case Reports

MeSH terms

Biopsy / adverse effects
COVID-19* / complications
Heart
Humans
Male
Middle Aged
Myocarditis* / pathology
Shock, Cardiogenic / complications