chest pain and high troponin level without significant respiratory symptoms in young patients with covid 19

• DOI: 10.22088/cjim.11.0.561
• Publication Date: 2020-01-01
• Authors: Kaveh Hosseini; Behnam Hedayat
• Keywords: acute myocarditis; covid-19; Case Report; Internal medicine; RC31-1245; acute coronary syndrome

BACKGROUND: Of all patients infected with COVID-19, 95% have mild symptoms, but 5% may experience severe illness. There are reports of myocardial injury associated with the COVID19 infection in middle-aged and old people with baseline cardiac conditions. Acute myocardial injury has been suggested as a marker for disease severity. Sometimes it is hard to differentiate between acute coronary syndrome and acute myocarditis; hence detailed history taking, lab tests and imaging will be necessary. CASE PRESENTATION: Herein, we described two young patients presenting with chest pain and no significant respiratory symptoms, one without cardiovascular risk factors and another one with diabetes mellitus and cigarette smoking. COVID-19 was documented with real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR). CONCLUSION: Early Chest CT scan besides coronary CT angiogram (if available) in suspicious cases can help physician to make fast decisions. These two cases both had complication-free hospital stay. Despite markedly high on-admission troponin levels, which is known as a marker of poor prognosis they discharged in good condition. One month follow-up was also uneventful.