Monkeypox, an infection that already affects 50,496, with 16 deaths, according to the World Health Organization (WHO), with the US being the country with the most registered cases (17,994) and Spain the second, with 6,543, also can affect the heart.
A study published in “JACC: Case Reports” presents the case of a 31-year-old man with confirmed monkeypox infection who developed acute myocarditis approximately one week after the onset of monkeypox symptoms.
Myocarditis is an inflammation of the heart muscle that is usually caused by a viral infection. This disease had previously been associated with infection with smallpox, a more aggressive virus, and the case study authors stated that “By extrapolation, monkeypox virus could have tropism for myocardial tissue or cause immune-mediated injury.” in the heart”.
“Through a case study, we are developing a deeper understanding of monkeypox, viral myocarditis, and how to accurately diagnose and manage this disease,” explains Julia Grapsa, editor-in-chief of “JACC: Case Reports ». “The authors of this study have used comprehensive magnetic resonance imaging (CMR), a comprehensive imaging tool, to aid in the diagnosis of myocarditis.”
Vaccination is recommended for people with known or suspected exposure to the virus
The patient presented to a health center five days after the onset of monkeypox symptoms, which included malaise, myalgia, fever, and multiple swollen lesions on the face, hands, and genitalia. Monkeypox infection was confirmed with a PCR swab sample from a skin lesion. The patient returned to the emergency department three days later, reporting tightness in the chest that radiated down the left arm.
The subject was admitted to an intensive care unit after an initial routine examination with clinical suspicion of acute myocarditis. The initial ECG showed sinus rhythm with nonspecific abnormalities of ventricular repolarization, and routine laboratory tests revealed elevated levels of C-reactive protein, creatine phosphokinase (CPK), high-sensitivity troponin I, and brain natriuretic peptide (BNP), all of which can indicate a stress injury to the heart. The results of the CMR study performed on the patient were consistent with myocardial inflammation and a diagnosis of acute myocarditis.
“This case highlights cardiac involvement as a possible complication associated with monkeypox infection,” said Ana Isabel Pinho, from the department of cardiology at Centro Hospitalario Universitario de São João, Portugal, and lead author of the study. “We believe that reporting this possible causal relationship may increase the awareness of the scientific community and health professionals about acute myocarditis as a possible complication associated with monkeypox; and could be useful for close follow-up of affected patients to recognize other complications in the future.”
The patient was discharged after one week with a complete recovery. The authors stated that more research is needed to identify the relationship between monkeypox and cardiac injury.
monkey pox is transmitted by close contact with lesions, body fluids or respiratory droplets. In addition to the rash, symptoms may include fever, chills, swollen lymph nodes, respiratory symptoms, and muscle aches. Most infections are mild, and symptoms can last two to four weeks. Vaccination is recommended for people with known or suspected exposure to the virus.