Other cardiovascular complications:
- Cardiac arrhythmias due to persistent myocardial damage and scar.
- Cardiac arrhythmias secondary to drug induced rhythm disturbances due to hydroxychloroquine and Remdesivir.
- Chronic myocardial damage can lead to heart failure.
- Elevated long-term cardiovascular risk in patients with history of pneumonia, hypercoagulability and residual systemic inflammatory activity.
- Non-cardiogenic pulmonary oedema and ARDS as well as multi-organ dysfunction due to altered vascular permeability.
Advantage of CMR: It allows for non-invasive assessment of myocardial injury. It is the modality of choice to distinguish ischemic from non-ischemic myocardial injury. Myocarditis, Takutsubo cardiomyopathy and myocardial infarction, as listed in the complications above, can be diagnosed and differentiated from one another by CMR. CMR utilising the Modified Lake Louise criteria defined by the presence of myocardial oedema, non-ischemic myocardial injury and supportive criteria such as pericarditis and systolic LV dysfunction can rightly diagnose myocarditis.
Learning point: CMR can help diagnose type of myocardial injury in COVID-19 recovered patients.