Inflammatory damage to the myocardium in patients with novel coronavirus disease (COVID-19)

The aim. To analyze current evidence about etiology, pathogenesis, clinical manifestation, diagnosis, and treatment of patients with COVID-19 associated myocarditis. Multisystem inflammatory syndrome is possible in including damage to the myocardium, which may last over several months worsen disease outcome. Mechanisms cardiac include direct by SARS-CoV-2, massive release cytokines, dysregulation renin-angiotensin system. All these factors can aggravate pre-existing overload right heart chambers multifocal pneumonia, thrombosis coronary arteries myocardial ischemia. Inflammation myocardium manifests typical symptoms myocarditis pericarditis. It be accompanied failure rapid decompensation, arrhythmia, acute or even sudden death. Laboratory findings high levels CRP, BNP, NT-proBNP, D-dimer. Transthoracic echocardiography allows for an assessment left ventricular dysfunction diagnosis a pericardial effusion. Heart MRI according Lake Louise Diagnostic Criteria most sensitive diagnostic method Medical imaging indicated only cases when results obtained potentially influence patient management tactics should performed shortest protocol due risks virus transmission. Conclusions. ESC experts (2020) do not provide unanimous recommendations SARS-CoV-2 myocarditis, considering lack base. Patient limited adequate failure, syndrome, prevention thrombotic complications. Ongoing studies are aiming evaluate potential place glucocorticoids, intravenous immunoglobulins, antibodies against IL-6 receptor, colchicine COVID-19.