Cardiology Letters 2023, 32(3):208-212

Stress cardiomyopathy in young woman after Cesarean section with SARS-CoV 2 inf

Nachtmann S¹, Pales J¹, Jalali Y¹, Jankovsky M¹, Brozmannova D², Minarova D², Sitar J², Payer J¹

¹ 5th Department of Internal Medicine of the Faculty of Medicine, Comenius University and University Hospital Bratislava, Bratislava

² CINRE, Bratislava, Slovak Republic

In this report, we present a case of a 42-year-old patient who underwent a Caesarean section at 33 weeks of pregnancy. The patient complained about persistent chest pain radiating to upper extremities. The objective findings were unremarkable, the ECG showed a sinus rhythm with an appropriate heart rate, negative T waves in V1-V3. Cardiac markers were elevated with negative dynamic change. As part of the differential diagnosis, a CT pulmonary angiography and a CT aortography were performed and excluded embolization to the pulmonary artery and acute aortic syndrome. However, there was an incidental finding of interstitial pulmonary oedema. Subsequent echocardiographic examination showed left ventricular regional wall movement abnormalities of interventricular septum, borderline reduction of left ventricular ejection fraction, and a smaller pericardial effusion, without tamponade. Consequently, the patient was referred to the cardiac centre for selective coronarography, which showed normal coronary arteries. Left ventriculography revealed regional kinetic disorders consistent with midventricular stress cardiomyopathy. A COVID-19 antigen test was performed, which yielded a positive result. The patient was without chest pain, showed no signs of congestion and did not require any heart failure treatment as her clinical status had spontaneously improved.

Keywords: acute cardiac injury; cardiomyopathy; myocarditis; cardiac specific markers

Published: March 1, 2023  Show citation