Background SARS-coronavirus-2 [coronavirus disease 2019 (COVID-19)] infection is a public health issue affecting millions of people. It started in Wuhan in China in December 2019 spreading rapidly worldwide. Case summary Three patients aged 51–84 developed a pericarditis related to COVID-19, associated for two of them with a myocarditis. Case 1 was a COVID-19 cardiac tamponade without myocarditis, confirmed by a positive chest computed tomography (CT) scan. Case 2 showed a COVID-19 myopericarditis, confirmed by a positive chest CT scan and a SARS-coronavirus-2 positive swab. Case 3 was a cardiac tamponade due to COVID-19 pericarditis, with a positive polymerase chain reaction on pericardial fluid. They were all treated by colchicine and their condition improved rapidly. Discussion Presumably rare, we reported three cases of pericardial effusions (PEs) occurring in a single cardiology centre. There is a higher incidence of COVID-19-related cardiac diseases such as pericarditis that can manifest as a minimal PE to a cardiac tamponade, which should result in a higher awareness of cardiologists. A systematic measure of the high-sensitivity troponin kinetic in patients affected by COVID-19 could be interesting in order to screen for potential myocarditis. Any unexplained haemodynamic failure or increased cardiac biomarkers should make the medical team search for myopericarditis by a transthoracic echocardiography.

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Background With the emergence of coronary computed tomography (CT) angiography, anomalous aortic origin of a coronary artery (ANOCOR) is more frequently diagnosed. Fractional flow reserve derived from CT (FFRCT) is a noninvasive functional test providing anatomical and functional evaluation of the overall coronary tree. These unique features of anatomical and functional evaluation derived from CT could help for the management of patients with ANOCOR. We aimed to retrospectively evaluate the physiological and clinical impact of FFRCT analysis in the ANOCOR registry population. Methods and Results The ANOCOR registry included patients with ANOCOR detected during invasive coronary angiography or coronary CT angiography between January 2010 and January 2013, with a planned 5‐year follow‐up. We retrospectively performed FFRCT analysis in patients with coronary CT angiography of adequate quality. Follow‐up was performed with a clinical composite end point (cardiac death, myocardial infarction, and unplanned revascularization). We obtained successful FFRCT analyses and 5‐year clinical follow‐up in 54 patients (average age, 60±13 years). Thirty‐eight (70%) patients had conservative treatment, and 16 (30%) patients had coronary revascularization after coronary CT angiography. The presence of an ANOCOR course was associated with a moderate reduction of FFRCT value from 1.0 at the ostium to 0.90±0.10 downstream the ectopic course and 0.82±0.11 distally. No significant difference in FFRCT values was identified between at‐risk and not at‐risk ANOCOR. After a 5‐year follow‐up, only one unplanned percutaneous revascularization was reported. Conclusions The presence of ANOCOR was associated with a moderate hemodynamic decrease of FFRCT values and associated with a low risk of cardiovascular events after a 5‐year follow‐up in this middle‐aged population.

Background SARS-Coronavirus-2 (COVID-19) infection is a pandemic with various clinical presentations including pericarditis which seems to be rare. Purpose The aim of this observational cohort study was to describe characteristics and management of the patients hospitalized for pericarditis secondary to COVID 19 in the Hospital of Haguenau, France. Methods We retrospectively enrolled patients admitted for pericarditis secondary to COVID 19 affection, either confirmed by a typical chest CT scan, or a positive Covid 19 PCR. Data were collected by a careful review of their medical record. Results 7 patients (4 men, 3 women) were included, with a median age of 60 and a median body mass index of 27.8 kg/m 2 . One of them took angiotensin II receptor antagonists, and none angiotensin converting enzyme inhibitors. Chest pain and dyspnea were the most common initial symptoms. Pericarditis were diagnosed with a median delay of 21 days after the onset of symptoms. The biology showed an inflammatory syndrome (median CRP at 104 mg/L). The troponin peak value was increased in two cases. Chest computed tomography revealed a typical lung COVID-19 affection in 4 cases and a pericardial effusion in every cases. Left ventricle ejection fraction assessed by echocardiography was normal. Two cases evolved into cardiac tamponade, which needed pericardiocentesis. One of the two cases of tamponade had a negative COVID 19 nasopharyngeal PCR and no pulmonary sign of the affection on the chest CT, but the Covid-19 PCR on pericardial fluid was positive. One patient required oxygen supply. Treatment with Colchicine was systematically initiated. Non-steroidal anti-inflammatory drugs were not introduced considering the risk of respiratory worsening. The 1-month follow-up revealed no death and a decrease of the pericardial effusion. Conclusion This study suggest a higher prevalence of COVID-19-associated pericarditis than initially presumed, with heterogeneous clinical presentations.

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