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Acute heart failure due to COVID-19 related myocardial injury and de novo hypertensive cardiomyopathy: a challenging multi-modality diagnosis
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  • Matteo Pernigo,
  • Marco Triggiani,
  • Emanuele Gavazzi,
  • Ilaria Papa,
  • Alberto Vaccari,
  • Simona Fisogni,
  • Ester Costantino,
  • Gian Franco Pasini
Matteo Pernigo
ASST del Garda
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Marco Triggiani
ASST del Garda
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Emanuele Gavazzi
University of Brescia
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Ilaria Papa
ASST del Garda
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Alberto Vaccari
ASST del Garda
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Simona Fisogni
University of Brescia
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Ester Costantino
ASST del Garda
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Gian Franco Pasini
ASST del Garda
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Abstract

We report a COVID19 case with acute heart and kidney failure in a healthy young male. Echocardiography showed severe systolic and diastolic left ventricle dysfunction, with diffuse myocardial thickening. Cardiac MRI showed aspects of focal myocarditis, and hypertensive cardiomyopathy. Renal biopsy demonstrated limited acute tubular injury, and hypertensive kidney disease. Coronary angiography excluded critical stenoses. Unlike what we initially suspected, myocardial inflammation had a limited extent in our patient; severe hypertension causing cardiomyopathy and multi-organ damage, not diagnosed before, was primarily responsible for severe illness. Correct diagnosis and guidelines-directed treatment allowed a favorable course.

Peer review status:UNDER REVIEW

11 Nov 2020Submitted to Echocardiography
16 Nov 2020Assigned to Editor
16 Nov 2020Submission Checks Completed
16 Nov 2020Reviewer(s) Assigned