Acute heart failure due to COVID-19 related myocardial injury and de novo hypertensive cardiomyopathy: a challenging diagnosis


  • Matteo Pernigo | Cardiology Unit, ‘La Memoria’ Hospital, Gavardo (BS) , Italy.
  • Marco Triggiani Cardiology Unit, ‘La Memoria’ Hospital, Gavardo (BS), Italy.
  • Emanuele Gavazzi Institute of Radiology, Department of Medical and surgical Specialties, University of Brescia, Italy.
  • Ilaria Papa Cardiology Unit, ‘La Memoria’ Hospital, Gavardo (BS), Italy.
  • Alberto Vaccari Cardiology Unit, ‘La Memoria’ Hospital, Gavardo (BS), Italy.
  • Simona Fisogni Institute of Anatomical Pathology, Department of Medical and Surgical Specialties, University of Brescia, Italy.
  • Ester Costantino Nephrology Unit, ‘La Memoria’ Hospital, Gavardo (BS), Italy.
  • Gian Franco Pasini Cardiology Unit, ‘La Memoria’ Hospital, Gavardo (BS), Italy.


We report a COVID-19 case with acute heart and kidney failure in a healthy young male. Echocardiography showed severe systolic and diastolic left ventricle dysfunction, with diffuse myocardial thickening. Cardiac MRI showed aspects of focal myocarditis, and hypertensive cardiomyopathy. Renal biopsy demonstrated limited acute tubular injury, and hypertensive kidney disease. Coronary angiography excluded critical stenoses. Unlike what we initially suspected, myocardial inflammation had a limited extent in our patient; severe hypertension causing cardiomyopathy and multi-organ damage, not diagnosed before, was primarily responsible for severe illness. Correct diagnosis and guidelines-directed treatment allowed a favorable course.



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COVID-19 - Collection of articles on the Coronavirus outbreak
COVID-19, myocarditis, cardiac MRI, hypertensive cardiomyopathy, echocardiography
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How to Cite
Pernigo, Matteo, Marco Triggiani, Emanuele Gavazzi, Ilaria Papa, Alberto Vaccari, Simona Fisogni, Ester Costantino, and Gian Franco Pasini. 2021. “Acute Heart Failure Due to COVID-19 Related Myocardial Injury and De Novo Hypertensive Cardiomyopathy: A Challenging Diagnosis”. Monaldi Archives for Chest Disease, September.

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