Scientists from São João University Hospital Center found a 31-year-old male with confirmed monkeypox infection developed acute myocarditis approximately one week following the onset of monkeypox symptoms.
Monkeypox is a disease caused by the monkeypox virus, part of the same family as the virus that causes smallpox, which causes a pimple or blister-like rash on the hands, feet, face, genitals, and other parts of the body.
Monkeypox was first reported in the EU in May 2022, as well as in the United States and other non-endemic countries, and cases are increasing.
Myocarditis, an inflammation of the heart muscle, is typically caused by a viral infection. Myocarditis was previously associated with smallpox infection, a more aggressive virus.
The team says by extrapolation, the monkeypox virus could have tropism for myocardium tissue or cause immune-mediated injury to the heart.
In the study, the patient presented to a health clinic five days following the onset of monkeypox symptoms, including malaise, myalgia, fever, and multiple swollen lesions on the face, hands, and genitalia.
Positive monkeypox infection was confirmed with a PCR swab sample of a skin lesion. The patient returned to the emergency department three days later reporting chest tightness radiating through the left arm.
The patient was admitted to an intensive care unit following an initial routine examination with the clinical suspicion of acute myocarditis.
The initial ECG showed sinus rhythm with nonspecific ventricular repolarization abnormalities 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 stress injury to the heart.
The results of the cardiac magnetic resonance (CMR) study performed on the patient were consistent with myocardial inflammation and a diagnosis of acute myocarditis.
The team says this case highlights cardiac involvement as a potential complication associated with monkeypox infection.
They believe that reporting this potential causal relationship can raise more awareness of the scientific community and health professionals for acute myocarditis as a possible complication associated with monkeypox, and might be helpful for close monitoring of affected patients for further recognition of other complications in the future.
The patient was discharged after one week with a full recovery. The team says further research is needed to identify the relationship between monkeypox and heart injury.
If you care about Monkeypox, please read studies about new symptoms of monkeypox, and whether monkeypox is the next pandemic.
For more information about the pandemic, please see recent studies that half of the people with COVID-19 have long COVID symptoms and results showing scientists find antibodies that block all the COVID-19 variants.
The research was published in JACC: Case Reports and conducted by Ana Isabel Pinho et al.
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