Table 1.

Mechanisms of Myocardial Injury

	Hypothesized Mechanism of Injury
Myocarditis	Systemic inflammatory response; direct myocardial cell injury via viral entry using ACE-2 receptor; T-cell–mediated immune response
Myocardial infarction	Plaque rupture (Type I MI); myocardial oxygen supply/demand mismatch (Type II MI) from increased cardiometabolic demand
Microangiopathy/cytokine storm	Cytokine-induced activation of microvasculature predisposing to vasomotor abnormalities; augmented thrombosis and other aspects of dysfunction
Arrhythmia	Hypoxia-mediated; coronary perfusion impairment; direct tissue injury; scar-mediated injury, inflammatory response; medication-induced; electrolyte abnormality.

ACE indicates angiotensin-converting enzyme; and MI, myocardial infarction.