Lauren Cairns1, Yazeed Abed El Khaleq2, Will Storrar2, Michaela Scheuermann-Freestone2. 1. Basingstoke and North Hampshire Hospital, Hampshire Hospitals Foundation Trust, Hampshire, United Kingdom. lmcairns@doctors.org.uk. 2. Basingstoke and North Hampshire Hospital, Hampshire Hospitals Foundation Trust, Hampshire, United Kingdom.
Abstract
BACKGROUND: Previous reports have shown various cardiac complications to be associated with COVID-19 including: myocardial infarction, microembolic complications, myocardial injury, arrythmia, heart failure, coronary vasospasm, non-ischemic cardiomyopathy, stress (Takotsubo) cardiomyopathy, pericarditis and myocarditis. These COVID-19 cardiac complications were associated with respiratory symptoms. However, our case illustrates that COVID-19 myopericarditis with cardiac tamponade can present without respiratory symptoms. CASE PRESENTATION: A 58-year-old Caucasian British woman was admitted with fever, diarrhoea and vomiting. She developed cardiogenic shock and Transthoracic echocardiogram (TTE) found a pericardial effusion with evidence of cardiac tamponade. A nasopharyngeal swab showed a COVID-19 positive result, despite no respiratory symptoms on presentation. A pericardial drain was inserted and vasopressor support required on intensive treatment unit (ITU). The drain was removed as she improved, an antibiotic course was given and she was discharged on day 12. CONCLUSIONS: Our case demonstrates that patients without respiratory symptoms could have COVID-19 and develop cardiac complications. These findings can aid timely diagnosis of potentially life-threatening COVID-19 myopericarditis with cardiac tamponade.
BACKGROUND: Previous reports have shown various cardiac complications to be associated with COVID-19 including: myocardial infarction, microembolic complications, myocardial injury, arrythmia, heart failure, coronary vasospasm, non-ischemic cardiomyopathy, stress (Takotsubo) cardiomyopathy, pericarditis and myocarditis. These COVID-19cardiac complications were associated with respiratory symptoms. However, our case illustrates that COVID-19 myopericarditis with cardiac tamponade can present without respiratory symptoms. CASE PRESENTATION: A 58-year-old Caucasian British woman was admitted with fever, diarrhoea and vomiting. She developed cardiogenic shock and Transthoracic echocardiogram (TTE) found a pericardial effusion with evidence of cardiac tamponade. A nasopharyngeal swab showed a COVID-19 positive result, despite no respiratory symptoms on presentation. A pericardial drain was inserted and vasopressor support required on intensive treatment unit (ITU). The drain was removed as she improved, an antibiotic course was given and she was discharged on day 12. CONCLUSIONS: Our case demonstrates that patients without respiratory symptoms could have COVID-19 and develop cardiac complications. These findings can aid timely diagnosis of potentially life-threatening COVID-19 myopericarditis with cardiac tamponade.
Entities:
Keywords:
COVID-19; Cardiac complications; Cardiac tamponade; Case report; Myocardial
Authors: Nauman Khalid; Yuefeng Chen; Brian C Case; Evan Shlofmitz; Jason P Wermers; Toby Rogers; Itsik Ben-Dor; Ron Waksman Journal: Cardiovasc Revasc Med Date: 2020-05-15
Authors: Elissa Driggin; Mahesh V Madhavan; Behnood Bikdeli; Taylor Chuich; Justin Laracy; Giuseppe Biondi-Zoccai; Tyler S Brown; Caroline Der Nigoghossian; David A Zidar; Jennifer Haythe; Daniel Brodie; Joshua A Beckman; Ajay J Kirtane; Gregg W Stone; Harlan M Krumholz; Sahil A Parikh Journal: J Am Coll Cardiol Date: 2020-03-19 Impact factor: 24.094