{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T22:08:39Z","timestamp":1785017319825,"version":"3.55.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"FI1","license":[{"start":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T00:00:00Z","timestamp":1598313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In the ongoing pandemic of COVID-19, respiratory failure has been reported as the main cause of death in those who develop critical illness. A few cases of concurrent myocarditis have been reported, but the extent of cardiac complications with the SARS-CoV-2 strain of coronavirus is still largely unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 53-year-old man, suspected to have COVID-19 due to a new-onset cough, shortness of breath, and hypoxia, was referred to Cardiology with sudden symptomatic bradycardia. Initial rhythm analysis revealed Type 2 atrioventricular block (Mobitz II). On arrival at the coronary care unit, he was found to be in complete heart block (Type 3). Routine blood tests showed normal electrolytes and renal function, and no elevation in troponin-I levels. Echocardiography showed mild impairment in left ventricular systolic function, with no regional wall motion abnormalities or valvular lesions. He then developed high-degree AV block lasting 6.2 s, prompting the need for an urgent permanent pacemaker implantation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Just over a third of patients with myocarditis reportedly develop a rise in cardiac troponin. Clinically suspected myocarditis can occur in the absence of a troponin rise and rarely can cause high-grade bradyarrhythmias. Myocarditis and non-specific cardiac arrhythmias have been reported in a few cases of COVID-19, but this is the first reported case of a high-grade atrioventricular conduction block with SARS-CoV-2 infection.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa248","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T09:37:15Z","timestamp":1598348235000},"page":"1-6","source":"Crossref","is-referenced-by-count":20,"title":["Case report: high-grade atrioventricular block in suspected COVID-19 myocarditis"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4178-9899","authenticated-orcid":false,"given":"Vishnu","family":"Ashok","sequence":"first","affiliation":[{"name":"Department of Cardiology, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei Ian","family":"Loke","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"2021012109525571400_ytaa248-B1","year":"2020"},{"key":"2021012109525571400_ytaa248-B2"},{"key":"2021012109525571400_ytaa248-B3"},{"key":"2021012109525571400_ytaa248-B4","doi-asserted-by":"crossref","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and Important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"2021012109525571400_ytaa248-B5","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan,","volume":"395","author":"Huang","year":"2020","journal-title":"China. Lancet"},{"key":"2021012109525571400_ytaa248-B6","doi-asserted-by":"crossref","first-page":"E1333","DOI":"10.21037\/jtd.2016.10.60","article-title":"Myocarditis with very high troponins: risk stratification by cardiac magnetic resonance","volume":"8","author":"Janardhanan","year":"2016","journal-title":"J Thorac Dis"},{"key":"2021012109525571400_ytaa248-B7","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1111\/j.1540-8159.2012.03489.x","article-title":"A review on advanced atrioventricular block in young or middle-aged adults","volume":"35","author":"Barra","year":"2013","journal-title":"Pacing Clin Electrophysiol"},{"key":"2021012109525571400_ytaa248-B8","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1007\/s000590050021","article-title":"The European Study of Epidemiology and Treatment of Cardiac Inflammatory Diseases (ESETCID): first epidemiological results","volume":"25","author":"Hufnagel","year":"2000","journal-title":"Herz"},{"key":"2021012109525571400_ytaa248-B9","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1007\/s00134-020-05991-x","article-title":"Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China","volume":"46","author":"Ruan","year":"2020","journal-title":"Intensive Care Med"},{"key":"2021012109525571400_ytaa248-B10","doi-asserted-by":"crossref","DOI":"10.1093\/ehjcr\/ytaa157","article-title":"Subacute perimyocarditis in a young patient with COVID-19 infection","author":"Monmeneu","year":"2020","journal-title":"Eur Heart J Case Rep"},{"key":"2021012109525571400_ytaa248-B11","doi-asserted-by":"crossref","first-page":"2636","DOI":"10.1093\/eurheartj\/eht210","article-title":"European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases","volume":"34","author":"Caforio","year":"2013","journal-title":"Eur Heart J"},{"key":"2021012109525571400_ytaa248-B12","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1016\/S0735-1097(97)00317-3","article-title":"Cardiac troponin T in patients with clinically suspected myocarditis","volume":"30","author":"Lauer","year":"1997","journal-title":"J Am Coll Cardiol"},{"key":"2021012109525571400_ytaa248-B13","doi-asserted-by":"crossref","DOI":"10.1016\/j.pcad.2020.03.001","article-title":"Sanchis-Gomar F. Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): evidence from a meta-analysis","author":"Lippi","year":"2020","journal-title":"Prog Cardiovasc Dis"},{"key":"2021012109525571400_ytaa248-B14","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA"},{"key":"2021012109525571400_ytaa248-B15","doi-asserted-by":"crossref","DOI":"10.1093\/ehjcr\/ytaa132","article-title":"Novel coronavirus 19 (COVID-19) associated sinus node dysfunction: a case series","author":"Peigh","year":"2020","journal-title":"Eur Heart J Case Rep"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/FI1\/1\/35930341\/ytaa248.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/FI1\/1\/35930341\/ytaa248.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T14:58:57Z","timestamp":1611241137000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/4\/FI1\/1\/5896829"}},"subtitle":[],"editor":[{"given":"Borislav","family":"Dinov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Robert","family":"Sch\u00f5nbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"David","family":"Niederseer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Christian Fielder","family":"Camm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Ross","family":"Thomson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,8,25]]},"references-count":15,"journal-issue":{"issue":"FI1","published-print":{"date-parts":[[2020,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaa248","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,10]]},"published":{"date-parts":[[2020,8,25]]}}}