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.