Myo-Pericarditis in the Context if MIS-A Syndrome: A Short Review Based on a Miscellaneous Case Following COVID-19 Infection

Maria Ioannou, Angeliki Mouzarou, Maria Skarpari, Elena Xenofontos, Andreas Kostis, Aristos Aristodimou, Elena Leonidou.

Abstract

Myo-pericarditis is characterized by inflammation that affects the myocardium and extends to the pericardium. This heart condition can vary in severity and requires a comprehensive diagnostic approach due to numerous potential causes. This is particularly challenging in the context of coronavirus disease (COVID-19) infection, due to the related potential complications that may emerge. In response to COVID-19, the immune system has already been associated with an explosion of powerful inflammatory alarm signals that trigger inflammation. Multisystem inflammatory syndrome in adults (MIS-A syndrome) is an under-recognized hyperinflammatory condition that occurs during or after the infectious period of COVID-19. This manifestation can affect multiple organs, including the heart, and can also cause myo-pericarditis. We present a complex case marked by intricate clinical presentation, extensive diagnostic evaluation, and multiple therapeutic interventions, highlighting the need for ongoing re-assessment of the diagnosis. Additionally, a brief literature review examines the pathologies complicating our diagnostic approach, aiming to elucidate the challenges inherent in diagnosing febrile myo-pericarditis. Given the diverse manifestations and overlapping symptoms, a refined diagnostic strategy is essential for accurate identification and effective management.