The University of Toledo Translation Journal of Medical Sciences 
Internal Medicine Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

A Case of Acute Myopericarditis in a 
Patient with Human Metapneumovirus 
(hMPV) Respiratory Infection 
Li Wang, MD1*, Basmah Khalil, MD1, Claudiu Georgescu, MD2 

1Division of Internal Medicine, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 
2Division of Infectious Diseases, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 

*Corresponding author: Li.Wang5@utoledo.edu

Published: 05 May 2023 

Human metapneumovirus (hMPV), a relatively newly isolated virus, has emerged as one of the most 
common pathogens implicated in respiratory tract infections worldwide. Although very rare, myocarditis 
has also been associated with this viral infection. A 36-year-old male with type 2 diabetes and essential 
hypertension presented to the emergency room with one-day chest pain and persistent cough for 3 
weeks. His chest pain was pleuritic, alleviated by sitting up. He was hemodynamically stable and 
physical examination was unremarkable except for lower extremity edema. Troponin and EKG were 
unremarkable. BNP was elevated at 308 pg/mL, and D-dimer was high at 0.8 mcg/mL. ESR and CRP 
were both elevated at 16 mm/hr and 79.6 mg/L respectively. CT angiography of the chest revealed tree-
in-bud like opacities in the left upper lobe and ground-glass opacities in the right lung. TTE revealed 
diffuse global hypokinesis and an ejection fraction of 30-35%. Cardiac MRI showed diffuse hypokinesia 
and myopericarditis. Infectious workup was only positive for hMPV on respiratory pathogen panel 
(RPP). The patient was diagnosed with hMPV pneumonia, complicated by acute myopericarditis and 
new onset systolic heart failure. He was treated with ibuprofen and colchicine, and guideline-directed 
medical therapy for systolic heart failure. With the rising popularity of RPP tests in recent years, the 
increasing detection of hMPV infections will shed more light on its association with myopericarditis. 
hMPV is ubiquitous and this case highlights the importance of recognizing the cardiovascular effect of 
the virus, especially in patients with respiratory tract infection symptoms. 

https://dx.doi.org/10.46570/utjms.vol11-2023-726 

https://dx.doi.org/10.46570/utjms.vol11-2023-726
mailto:Li.Wang5@utoledo.edu