Chest pain and high troponin level without significant respiratory symptoms in young patients with COVID-19

Caspian J Intern Med. 2020 Fall;11(Suppl 1):561-565. doi: 10.22088/cjim.11.0.561.

Abstract

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.

Keywords: COVID-19; acute coronary syndrome; acute myocarditis.

Publication types

  • Case Reports