Acute myocardial injury in COVID19:

• Most common: Type 2 MI = demand ischemia 
• Type 1 MI = STEMI
• Acute cardiomyopathy – acute myocarditis, acute pericarditis, or acute stress cardiomyopathy 

Acute myocarditis – myocardial inflammation in absence of ischemia  

            Many causes (viral, bacterial, immune, etc) 

            ECG most common finding = sinus tachycardia w/ nonspecific ST/T changes 

                        Can see STEMI, wide QRS, prolong QTc, TWI 

            *persistent tachycardia in viral syndrome* 

Can cause cardiogenic shock or arrhythmias 

Example: Patient with myocarditis

Acute pericarditis – diffuse STE w/ PR depression (prominent in II, V5), STD in only aVR and V1 

Acute stress cardiomyopathy (Takotsubo) 

            New ECG changes w/ STE or TWI 

                        Can see prolong QTc

            Transient akinesia/dyskinesis of LV 

Hypokinetic mid to apical segment, hyperkinetic base

            Cardiac cath w/ nonobstructive CAD