Case 4: Syncope
A 32-year-old male was admitted with syncope following an episode of
chest pain. The patient experienced fever and myalgia four days before
admission. At the time of admission, the patient was confused. Also, he
complained of dyspnea and dry cough. Vital signs included temperature =
36.8, systolic blood pressure = 85/60 mmHg, heart rate = 120/min, and
O2 saturation = 80% without an oxygen supply. ECG
showed sinus tachycardia, low voltage limb leads, inverted T waves in
two limb leads (L1 and aVL), and ST-segment depression in three
pericardial leads (V1 to V3). TTE revealed LVEF = 25%, increased left
ventricle end-diastolic diameter, normal RV size (mild dysfunction), and
normal valvular and pericardial function. Moreover, echocardiography
revealed increased wall thickness. Lung CT scan showed diffuse bilateral
GGO in favor of COVID-19 (Figure 1D). The patient received
broad-spectrum antibiotics (meropenem and doxycycline) and remdesivir
for COVID-19. The patient was discharged after two weeks with an
ejection fraction of 45%. Following up the patient for three months
revealed LVEF of 45% and normal and functional RV.