With the onset of autumn 2024, the spread of coronavirus infection began to deteriorate again. The number of COVID-19 cases was increasing due to a new FLiRT subvariant of the virus. In the literature, a mild course of the disease has been described, but a severe course is possible in some cases.

OBJECTIVE

To describe a clinical case of severe course of viral pneumonia and spontaneous rupture in the thinned part of the left ventricular aneurysm of the myocardium.

MATERIALS AND METHODS

A clinical and pathoanatomical comparison of the data on the results of autopsy study was carried out. Histological material was stained with hematoxylin and eosin.

RESULTS

Case report. Patient, 55 years old, was hospitalized for several hours in a republican cardiology health center. The patient complained of shortness of breath, pain under her left shoulder blade, rapid heartbeat. According to electrocardiogram data: sinus tachycardia with heart rate up to 120 b/min, upsloping ST-segment elevation up to 1 mm in the V₁—V₆ leads. According to the CT findings, there are signs of bilateral viral interstitial pneumonia with an area of infection equal to 61%. Past history of arterial hypertension, post-infarction cardiosclerosis (acute myocardial infarction in 2019). Troponin I level — 0.08 (norm — up to 0.02) ng/ml. Fatal outcome occurred suddenly. The result of autopsy material virology testing: FLiRT strain was detected in the lung tissue and in the rupture of the wall of the left ventricular myocardium. In the autopsy study, signs of viral interstitial pneumonia have been identified in the lungs, in the heart — a penetrating defect 1.5 cm in size with uneven edges has been noted in the region of the cardiac apex in the area of post-infarction cardiosclerosis.

CONCLUSION

The presence of endothelial cells in the lumen of the lungs’ microvasculature vessels, that suggests the haemorrhagic shock development, is the feature of detected microscopic changes. The phenomenon of vascular walls lining with fibrin is associated with the endothelium damage.