A 37-year-old male patient was admitted to hospital on 14 January 2020, with chest pain and dyspnoea for 3 days, accompanied by diarrhoea His blood pressure decreased to 80/50 mmHg X-ray chest film showed significant enlargement of the heart (Panel A: cardiothoracic ratio 0 70) Chest computed tomography (CT) examination indicated pulmonary infection, enlarged heart, and pleural effusion (Panels B and C) The electrocardiogram suspected ST-segment elevation acute myocardial infarction (III, AVF ST-segment elevation, Panels D and E), an emergency CT coronary angiography revealed no coronary stenosis Markers of myocardial injury were significantly elevated Troponin T was more than 10 000 ng/L Creatine kinase isoenzyme CKMB 112 9 ng/L Natriuretic peptide BNP was up to 21 025 ng/L Echocardiography revealed an enlarged heart and a marked decrease in ventricular systolic function [left ventricle (end diastolic) dimension (LV) 58 mm, left atrium dimension (LA) 39 mm, right ventricle dimension (RV) 25 mm, right atrium dimension (RA) 48 mm, left ventricular ejection fraction (LVEF) 27%, trace 2 mm pericardial effusion] Sputum was examined for 13 viral nucleic acids related to respiratory tract Only the coronavirus nucleic acid test was positive All of the other 12 nucleic acid tests were negative, including influenza A virus, adenovirus, bocavirus, rhinovirus, influenza A(H1N1) 2009, parainfluenza, chlamydia, partial pulmonary virus, influenza B virus, mycoplasma pneumoniae, influenza A virus H3N2, and respiratory syncytial virus The diagnosis of this patient is coronavirus fulminant myocarditis with cardiogenic shock and pulmonary infection

中文翻译：

---

糖皮质激素和人免疫球蛋白治疗冠状病毒暴发性心肌炎

一名 37 岁男性患者于 2020 年 1 月 14 日入院，胸痛、呼吸困难 3 天，伴有腹泻，血压降至 80/50 mmHg X 线胸片显示心脏明显增大（图 A：心胸比 0 70) 胸部计算机断层扫描 (CT) 检查提示肺部感染、心脏扩大和胸腔积液（图 B 和 C） 心电图怀疑 ST 段抬高型急性心肌梗死（III，AVF ST 段抬高，面板 D 和 E)，急诊 CT 冠状动脉造影显示无冠状动脉狭窄 心肌损伤标志物显着升高 肌钙蛋白 T 超过 10 000 ng/L 肌酸激酶同工酶 CKMB 112 9 ng/L 利钠肽 BNP 高达 21 025 ng/L 超声心动图显示扩大心脏和心室收缩功能显着下降 [左心室（舒张末期）尺寸 (LV) 58 毫米，左心房尺寸 (LA) 39 毫米，右心室尺寸 (RV) 25 毫米，右心房尺寸 (RA) 48 毫米，左心室射血分数（LVEF）27%，微量2mm心包积液] 痰检测呼吸道相关病毒核酸13项 仅冠状病毒核酸检测阳性 其他12项核酸检测均为阴性，包括甲型流感病毒，腺病毒，博卡病毒，鼻病毒，2009 年甲型 H1N1 流感，副流感、衣原体、部分肺病毒、乙型流感病毒、肺炎支原体、甲型流感病毒H3N2、呼吸道合胞病毒 该患者诊断为冠状病毒暴发性心肌炎伴心源性休克和肺部感染