The Evaluation of Myocarditis in the Post-Covid-19 Era: Pearls and Perils for the Clinician

Abstract

Coronavirus disease 2019 (COVID-19), which is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), continues to remain a global threat since declared a pandemic by the World Health Organization in March 2020. While primarily a respiratory disease, its clinical manifestations vary widely ranging from asymptomatic infection to multi-organ failure and death. As more research becomes available, cardiovascular involvement including acute coronary syndrome, heart failure, arrhythmias, thromboembolism, myocarditis and pericarditis have been reported in both the acute infectious stage as well as the post-symptomatic period. Myocarditis is an inflammatory disease of the myocardium that can result from infectious or non-infectious causes including autoimmunity, drug and toxin exposures. This chapter discusses the incidence, pathology, diagnostic modalities, and the management of myocarditis with a special focus on the essential role of a comprehensive approach, while utilizing advanced cardiac imaging for the assessment of myocarditis in the post COVID-19 era.