Case 18-2020: A 73-Year-Old Man with Hypoxemic Respiratory Failure and Cardiac Dysfunction

A 73-year-old man with a history of hypertension, diabetes, and atrial fibrillation presented during the COVID-19 pandemic with hypoxemic respiratory failure and bilateral pulmonary infiltrates. Initial evaluation revealed elevated troponin levels, ST-segment abnormalities on ECG, and new biventricular dysfunction on echocardiography, suggestive of myopericarditis secondary to SARS-CoV-2 infection. The case highlights the diagnostic challenges of distinguishing COVID-19-related cardiac injury from acute coronary syndromes, as well as the complexities of managing arrhythmias (e.g., QT prolongation from hydroxychloroquine) and hemodynamic instability in critically ill patients. Despite supportive care and experimental therapies, the patient developed progressive renal failure and died

A 73-year-old man with a history of hypertension, diabetes, and atrial fibrillation presented during the COVID-19 pandemic with hypoxemic respiratory failure and bilateral pulmonary infiltrates. Initial evaluation revealed elevated troponin levels, ST-segment abnormalities on ECG, and new biventricular dysfunction on echocardiography, suggestive of myopericarditis secondary to SARS-CoV-2 infection. The case highlights the diagnostic challenges of distinguishing COVID-19-related cardiac injury from acute coronary syndromes, as well as the complexities of managing arrhythmias (e.g., QT prolongation from hydroxychloroquine) and hemodynamic instability in critically ill patients. Despite supportive care and experimental therapies, the patient developed progressive renal failure and died