Ventricular Tachycardia as the Initial Manifestation of COVID-19-Related Myocarditis: A Case Report

TL;DR

A previously healthy man developed ventricular tachycardia as the first sign of COVID-19-related myocarditis, highlighting the condition's unusual cardiac presentation.

Contribution

This case report presents ventricular tachycardia as an initial manifestation of asymptomatic SARS-CoV-2-related myocarditis.

Findings

A 53-year-old male with no prior heart issues developed sustained monomorphic ventricular tachycardia.

Cardiac MRI showed myocarditis consistent with SARS-CoV-2 infection despite no respiratory symptoms.

Treatment with amiodarone and colchicine prevented recurrence of ventricular tachycardia.

Abstract

We report the case of a 53-year-old previously healthy male who presented with sudden-onset palpitations, dizziness, and profuse sweating. Electrocardiography revealed a sustained monomorphic ventricular tachycardia (VT) requiring immediate direct current cardioversion and intravenous amiodarone due to hemodynamic instability. Initial workup, including cardiac biomarkers, echocardiography, and coronary angiography, showed no structural heart disease or coronary obstruction. Cardiac MRI demonstrated circumferential myocardial involvement consistent with myocarditis. Serology confirmed recent SARS-CoV-2 infection, though the patient remained asymptomatic for respiratory symptoms. The patient was managed with amiodarone and colchicine, with no VT recurrence during follow-up. This case highlights an unusual cardiac presentation of COVID-19 and underscores the importance of considering myocarditis in patients presenting with ventricular arrhythmias, even in the absence of typical infectious symptoms.

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