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, the researchers said.
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 said.
"This case highlights cardiac involvement as a potential complication associated with monkeypox infection," said 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.
Monkeypox has been spreading since spring in the United States, Europe and other regions where it had been rare previously. It is transmitted through close contact with the lesions, bodily fluids or respiratory droplets of an infected person.
Symptoms, which can last two to four weeks, include fever, chills, swollen lymph nodes, respiratory symptoms and muscle aches, as well as the characteristic skin lesions. Most cases are mild.
The virus is related to smallpox, which is more aggressive.
Health care experts recommend people with a known case of monkeypox or presumed exposure get vaccinated.
In the United States, gay and bisexual men make up the majority of cases in the current outbreak, according to the U.S. Centers for Disease Control and Prevention.
The U.S. Centers for Disease Control and Prevention has more on monkeypox.
SOURCE: JACC: Case Reports, news release, Sept. 2, 2022