Acute heart failure and complete AV block in a patient with severe Covid-19 pneumonia

We present the challenging case of a patient with severe COVID-19 pneumonia complicated with cardiogenic shock and refractory complete AV block. The patient presented with wall motion abnormalities on echocardiography, and cardiac magnetic resonance revealed finding compatible with myocarditis. Myocardial injury may occur in up to 31% of patients with Covid-19 pneumonia and has been related to increased mortality. However, whether myocardial injury might result from direct damage from the virus or related to complications of the disease is still unclear. Although myocarditis is not common in COVID patients, it should be considered as a possible diagnosis.