Myocarditis is considered to be among the most dangerous complications of either acute phase or long COVID-19 with rather heterogeneous clinical presentation and course that ranges from asymptomatic to life-threatening. Diverse clinical picture of presentation with high risk of further complications on the one hand and good prognosis in case of appropriate treatment on the other hand demand the great attention of doctors. We report the case of a 27-year-old male visited cardiologist with complaints of dyspnea, episodic stabbing retrosternal pain, palpitation that have occurred eight months after mild COVID-19 episode. He was vaccinated with COVID-19 mRNA Vaccine two months before COVID-19 episode. The diagnostic search commenced with a detailed questioning and physical examination with further laboratory set and instrumental procedures, including ECG at rest, 24-hours ECG monitoring, 2D transthorathic echocardiography at rest with speckle-tracking where myocardial cardiosclerosis was registered. We carried out the differential diagnosis between myocardial bridge, atherosclerotic plaque, and cardiosclerosis after myocarditis with stress echocardiography. Cardiac magnetic resonance with gadolinium contrast unlike cardiac computed tomography was the final step in diagnosis establishment. The changes in myocardium typical of myocarditis, namely diffuse myocardial fibrosis of non-ischemic genesis, were detected. Half a year follow-up period of the patient with asymptomatic manifestation of COVID-19 myocarditis demonstrated the normalization of the condition, particularly no complaints at rest as well as physical training, after prescribed pathogenetic treatment (rosuvastatin, dipyridamole, L-arginine hydrochloride, vitamin D3, trimetazidine hydrochloride). The aim of this case report is to raise awareness in the medical community on the necessity of prolonged follow-up of patients after COVID-19 episode, to propose a comprehensive approach to possible differential diagnostic search for precise diagnosis establishment and treatment in young male.

Yuliya Tyravska has completed her PHD in Medicine at the age of 33 years from Bogomolets National Medical University, Ukraine (PhD Thesis “Clinical and hemostasiologic parameters in patients with unstable angina and their dynamics during statin therapy”). Her spheres of scientific interest are coronary artery disease, particularly INOCA, methods of its instrumental and laboratory diagnostic, hemostasiology. She has over 60 publications, and her publication h-index is 4. She is reviewer of manuscripts of international journals including those indexed in Web of Science.