Coronavirus Myocarditis MRI (Short Axis)

A 53-year-old woman with 1 week of fever and cough who tested positive for severe acute respiratory syndrome coronavirus 2 on polymerase chain reaction developed diffuse electrocardiography changes, elevated levels of cardiac biomarkers, and diffuse echo-bright appearance of her myocardium with diffuse hypokinesis and a left ventricular (LV) ejection fraction of 40% on echocardiography. This cine sequence of short-axis cardiac magnetic resonance imaging shows increased wall thickness with diffuse biventricular hypokinesis, especially in the apical segments, and severe LV dysfunction (LV ejection fraction of 35%). Short tau inversion recovery and T2-mapping sequences showed marked biventricular myocardial interstitial edema. Phase-sensitive inversion recovery sequences showed diffuse late gadolinium enhancement extended to the entire biventricular wall. The myocardial edema and pattern of late gadolinium enhancement fulfilled all the Lake Louise criteria for the diagnosis of acute myocarditis, which in the first months of the pandemic is a newly recognized manifestation of coronavirus disease 2019 (COVID-19). Click the related article link for complete case details.