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.