• Tamara Naneishvili, Arsalan Khalil, Ryan O'Leary, and Neeraj Prasad.
• Department of Cardiology, County Hospital Hereford, Hereford, Herefordshire, UK Tamara.Naneishvili@nhs.net.
• BMJ Case Rep. 2020 Sep 14; 13 (9).

AbstractMyocarditis is well known to be caused by viral infections such as Coxsackie virus group B, human herpes virus 6 and parvovirus B19. However, during the current emerging outbreak of SARS-CoV-2, there have been few case reports describing myocarditis as a possible presentation. In our case report we describe, early cardiac manifestations of SARS-CoV-2 in a UK District General Hospital. A 44-year-old Caucasian woman without any comorbidities presented with SARS-CoV-2 related fulminant myocarditis without initial respiratory symptoms. Patient underwent treatment with milrinone and methylprednisolone that showed reduction in myocardial inflammation and significantly improved myocardial contractility. This was then followed by a second phase of SARS-CoV-2 associated pneumonia and renal failure requiring ventilatory support and haemofiltration. Although, not described in the literature, we have found conjunctive use of milrinone and methylprednisolone effective in patient with SARS-CoV-2 fulminant myocarditis.© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

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