Hemorrhagic pericardial effusion leading to cardiac tamponade, as presenting feature of COVID-19 in a young man: a case report
Keywords:
Key words:COVID-19,cardiac tamponade, pericardial effusion, case reportAbstract
Background:
Coronavirus disease 2019(COVID-19) is an acute respiratory illness, caused by Severe Acute Respiratory Syndrome Coronavirus2 (SARS-COV2) which quickly grew to a pandemic in late 2019 and led to substantial public health problems. Among the extrapulmonary manifestations reported, cardiovascular implications are remarkable as they can be potentially lethal. There have been rare reports of pericardial involvement, despite the pronounced cardiovascular complications including acute myocardial injury, myocarditis, arrhythmia, cardiogenic shock and venous thromboembolism. Herein, we reported a young man with cardiac tamponade as the presenting feature of COVID-19.
Case summary:
An otherwise healthy 28-year-old man, was admitted with pleuritic chest pain and shortness of breath and was diagnosed with COVID-19 associated cardiac tamponade. Emergency pericardiocentesis yielded large amount of hemorrhagic pericardial effusion which resulted in symptom relief. He was successfully treated with pericardiocentesis followed by anti-viral and anti-inflammatory medications and remained asymptomatic in 1-month follow-up.
Conclusion:
We highlight this case to mention that “hemorrhagic” cardiac tamponade can be a life-threatening complication of COVID-19, which can be treated if diagnosed early. Therefore, clinicians should be fully aware of this cardiac complication to consider in deteriorating COVID-19 patients.
References
Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive care medicine. 2020 Mar 3:1-3.
Mehra MR1, Desai SS1, Kuy S1, Henry TD1, Patel AN1. Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19.N Engl J Med. 2020 May 1. doi: 10.1056/NEJMoa2007621.
Nguyen JL, Yang W, Ito K, Matte TD, Shaman J, Kinney PL. Seasonal influenza infections and cardiovascular disease mortality. JAMA cardiology. 2016 Jun 1;1(3):274-81.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. New Engl J Med. 2020 Jan 24.
World health organization.coronavirus disease(COVID-19)situation reports.2020.
Sardu C, Gambardella J, Morelli MB, Wang X, Marfella R, Santulli G. Is COVID-19 an Endothelial Disease? Clinical and Basic Evidence. . Preprints 2020;10.20944
Inciardi RM, Lupi L, Zaccone G, Italia L, Raffo M, Tomasoni D, et al. Cardiac involvement in a patient with coronavirus disease 2019 (COVID-19). JAMA cardiol. 2020 Mar 27.
Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020;17(5):259-60.
Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Bondi-Zoccai G, et al. Cardiovascular considerations for patients, health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic. Journal of the American College of Cardiology. 2020 Mar 19.
Vetta F, Vetta G, Marinaccio L. Coronavirus Disease 2019 (COVID-19) and Cardiovascular Disease: A Vicious Circle. J Cardiol Cardiovasc Res. 2020;1(2):1-2.
Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. European Radiology. 2020 Mar 19:1-9.
Dabbagh MF, Aurora L, D’Souza P, Weinmann AJ, Bhargava P, Basir MB. Cardiac Tamponade Secondary to COVID-19. JACC: Case Reports. 2020 Apr 23.
Inciardi RM, Lupi L, Zaccone G, Italia L, Raffo M, Tomasoni D, et al. Cardiac involvement in a patient with coronavirus disease 2019 (COVID-19). JAMA cardiology. 2020 Mar 27.
Braunwald E. Pericardial disease. In Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison’s Principles of Internal Medicine, 18th ed. New York: McGraw-Hill, 2012, pp. 1971–8.
Hamasaki A, Uchida T, Yamashita A, Akabane K, Sadahiro M. Cardiac tamponade caused by acute coxsackievirus infection related pericarditis complicated by aortic stenosis in a hemodialysis patient: a case report. Surgical case reports. 2018 Dec 1;4(1):141.
Rivero A, Acena A, Orejas M, Hernandez-Estefania R. Recurrent haemorrhagic pericardial effusion due to idiopathic pericarditis: a case report. European Heart Journal-Case Reports. 2019 Mar;3(1):ytz018.
Singh R, Fuentes S, Ellison H, Chavez M, Hadidi OF, Khoshnevis G, et al. Case of Hemorrhagic Cardiac Tamponade in a Patient with COVID-19 Infection. CASE: Cardiovascular Imaging Case Reports. 2020 Jun 4.
Downloads
Published
Issue
Section
License
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
