Different Types of Myocardial Injury due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Variant Two Cases Report

Keishi Moriwaki; Naoki Fujimoto; Hiroaki Murakami; Kazuaki Maruyama; Masaki Ishida; Masaki Tanabe; Kyoko Imanaka-Yoshida; Kaoru Dohi

doi:10.1536/ihj.22-355

Case Reports

Different Types of Myocardial Injury due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Variant

Two Cases Report

Keishi Moriwaki, Naoki Fujimoto, Hiroaki Murakami, Kazuaki Maruyama, Masaki Ishida, Masaki Tanabe, Kyoko Imanaka-Yoshida, Kaoru Dohi

Author information

Keishi Moriwaki
Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
Naoki Fujimoto
Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
Hiroaki Murakami
Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
Kazuaki Maruyama
Department of Pathology and Matrix Biology, Mie University Graduate School of Medicine
Masaki Ishida
Department of Radiology, Mie University Graduate School of Medicine
Masaki Tanabe
Department of Infection Control and Prevention, Mie University Hospital
Kyoko Imanaka-Yoshida
Department of Radiology, Mie University Graduate School of Medicine
Kaoru Dohi
Department of Cardiology and Nephrology, Mie University Graduate School of Medicine

Keywords: COVID-19, Myocarditis, Histology, Cardiovascular magnetic resonance

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2023 Volume 64 Issue 1 Pages 85-89

DOI https://doi.org/10.1536/ihj.22-355

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Abstract

Coronavirus disease 2019 (COVID-19) associated myocardial injury was caused by various mechanisms. We herein describe 2 cases presenting different types of myocardial injury due to Omicron variant. In both patients, diffuse reduced left ventricular (LV) wall motion in transthoracic echocardiography, electrocardiographic abnormality, and elevated myocardial enzymes were demonstrated. In addition, cardiovascular magnetic resonance (CMR) findings fulfilled the 2018 Lake Louise Criteria (LLC) for myocarditis. However, histological findings in 1 patient showed inflammatory cell infiltration with myocyte degeneration, while those in the other showed interstitial edema without inflammatory cell infiltration. Histological findings were crucial for a differential diagnosis of myocardial injury due to Omicron variant.

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