CTICasesCOVID-19 Myocarditis with Left Ventricular Thrombus
Imaging findings
Cardiac MRI shows global left ventricular dilation and dysfunction (EF 30-40%) with areas of high myocardial t2 signal and myocardial enhancement of 168% on post-contrast images. Subsequent CT shows a new left ventricular thrombus and a fresh cerebral infarct in the frontal lobe. Chest CT shows peripheral ground-glass opacities.
Key takeaways
SARS-CoV-2 infection can lead to acute myocarditis, which can be diagnosed on cardiac MRI by Lake Louise criteria (myocardial edema and late gadolinium enhancement). A severe complication of COVID-19 myocarditis is left ventricular dysfunction predisposing to LV thrombus formation and subsequent embolic stroke. Cardiac symptoms can precede classic pulmonary findings.
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