Case 9: Chest Pain
A 28-year-old man was admitted with chest pain. He had a history of fever and dry cough three days before admission. Vital signs included temperature = 36.8, systolic blood pressure = 100/60 mmHg, heart rate = 92/min, and O2 saturation = 92% without an oxygen supply. ECG showed sinus rhythm with ST-segment elevation and Q waves in precordial leads. Angiography showed normal coronary arteries. Echocardiographic revealed LVEF = 30-35%, hypokinesia in the anterior wall, normal LV size, and normal RV size and function. Furthermore, the lung CT scan showed a bilateral GGO pattern (Figure 1I). The patient received IV broad-spectrum antibiotics (meropenem and doxycycline), high-dose corticosteroid (1 mg/kg methylprednisolone/day), and remdesivir for COVID-19 for seven days. After treatment, the LVEF improved to 45-50%. He recovered in three days and was discharged in good condition. Following up the patient for three months showed LVEF of 45-50% and normal cardiac function.