Monkeypox, the contagious virus that causes a blister-like skin rash, may also cause heart problems, according to a new case study.
In findings published Sept. 2 in JACC: Case Reports, doctors in Portugal described a 31-year-old patient with monkeypox who developed acute myocarditis about a week after his other symptoms started.
“Through this important case study, we are developing a deeper understanding of monkeypox, viral myocarditis and how to accurately diagnose and manage this disease,” said the journal’s editor-in-chief, Dr. Julia Grapsa. The authors used CMR mapping, an imaging tool, to help with the myocarditis diagnosis, she said in a journal news release.
Five days after his symptoms began, the man went to a health clinic with fever, muscle pain and swollen lesions on his face, hands and genitalia. Doctors confirmed he had monkeypox through a skin test.
Three days later, the patient was back in the emergency department complaining of chest tightness that was radiating through his left arm. After an exam, doctors suspected acute myocarditis and admitted the man to the intensive care unit.
An electrocardiogram found abnormalities and lab test results showed elevated levels of C-reactive protein, creatine phosphokinase (CPK), high-sensitivity troponin I and brain natriuretic peptide (BNP). All can indicate a stress injury to the heart, according to researchers.
A cardiac magnetic resonance (CMR) study was consistent with myocardial inflammation and a diagnosis of acute myocarditis.
The patient fully recovered after one week and was discharged from the hospital. More research is needed to identify the relationship between monkeypox and heart injury, the authors note.
“This case highlights cardiac involvement as a potential complication associated with monkeypox infection,” says lead author Dr. Ana Isabel Pinho of São João University Hospital Center in Portugal.
“We 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,” Pinho said in the release.
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Protecting yourself from monkeypox
Monkeypox has been spreading since spring in the United States, Europe and other regions where it had been