Man With Monkeypox Develops Serious Heart Issue, What to Know

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Monkey pox is currently spreading in several countries. Akacin Phonsawat/Getty Images
  • Researchers say monkeypox may be linked to heart problems.
  • A 31-year-old man tested positive for monkeypox and developed myocarditis.
  • The man made a full recovery.

Monkeypox can potentially cause heart damage in some patients, according to a new case study published Friday JACC: Case Reports.

A 31-year-old man tested positive for monkeypox and developed acute myocarditis – inflammation of the heart muscle – a week after developing monkeypox symptoms.

Researchers say the case report suggests that inflammation of the heart may be a rare complication associated with monkeypox.

According to dr. Jorge Salinasan infectious disease specialist and hospital epidemiologist at Stanford University, other viruses, including enteroviruses and the smallpox virus, which is related to the monkeypox virus, are known to affect the heart.

Other patients with a diagnosis monkey pox in 2022, they developed myocarditis, but infectious disease experts say this is likely a rare complication.

“As the outbreak continues, we will hear of a few more cases, but I don’t expect the number to be large,” Salinas told Healthline.

The patient, a healthy 31-year-old man, visited the health clinic five days after the onset of monkeypox symptoms. He suffered from malaise, myalgia, fever and multiple skin lesions.

He tested positive for monkeypox and returned to the emergency room three days later because he was experiencing chest pain and pressure in his left arm.

The patient underwent several heart tests that showed he had suffered stress damage to the heart. A cardiac magnetic resonance imaging test, which takes pictures of the heart, found that the patient had inflammation of the myocardium.

The patient made a full recovery within one week.

According to the researchers, this case suggests that myocarditis may be a complication of monkeypox, but more research is needed to further understand the link between monkeypox and heart injury.

“Clinicians should be alert in a patient with monkeypox who describes chest pain to look for this rare clinical manifestation, which completely resolved in this patient,” Doctor Monica Gándhíováinfectious disease specialist at the University of California, San Francisco, said.

Monkeypox usually causes self-limiting symptoms, including skin lesions, myalgia, and fever, which resolve within a few weeks.

Gandhi says that the recent outbreak of monkey pox – almost 52,000 cases in 110 countries — is the largest monkeypox epidemic the world has experienced since the infection was first described in 1958.

“Therefore, this outbreak provides an opportunity to define the clinical characteristics of this infection in more detail,” Gandhi said.

Myocarditis is a complication associated with many infectious diseases. History research found that viral infections are the most common cause of myocarditis.

“Myocarditis can be caused by a variety of viruses, from influenza to coxsackievirus, influenza virus, smallpox and SARS-CoV2,” dr. Amesh Adaljasenior scientist at the Johns Hopkins University Center for Health Security and an infectious disease expert, told Healthline.

Evidence has previously linked myocarditis to smallpox, which is more dangerous compared to monkeypox. Because monkeypox is related to smallpox, scientists believe that monkeypox can, in rare circumstances, similarly damage the heart.

“The smallpox virus is related to monkeypox and has been associated with myocarditis (inflammation of the heart), as has the smallpox vaccine,” Gandhi said.

Patients with viral myocarditis usually first experience fever, malaise, and myalgias before sudden onset of cardiac symptoms.

The inflammation is likely caused by the virus itself along with inflammation resulting from the body’s immune response.

“In some cases, it is a direct viral invasion of cardiac myocytes with subsequent dysfunction. In other cases, it can be an immune response to a pathogen causing heart damage,” said Adalja, adding that it could also be a combination of both.

Adalja doesn’t expect myocarditis to be a common problem in people diagnosed with monkeypox.

“Myocarditis does not seem to be a common complication of monkeypox – hence only one case report,” Adalja said.

A new case study detailing a healthy man in his 30s who was diagnosed with monkeypox and later developed myocarditis suggests the infection has the potential to cause heart damage in some patients. Infectious disease experts say heart inflammation is linked to other infectious diseases, but they expect it to be a rare complication of monkeypox.

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