Background: The coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (sarscov2), has been shown to cause conventional respiratory distress, in addition to that, there has been recent reports suggesting the cardiovascular system involvement during the course of the infection, including microthrombosis and cardiopulmonary serosal layers infection and inammation although being separately described. The present paper demonstrates the rst reported case of the concomitant presence of intra-cardiac free- oating microthrombi and pericardial effusion secondary to COVID-19 infection, beyond the casual clinical presentation. Case report :A 51 year-old man with no medical history, presented to the emergency department, with a progressively worsening dyspnea, he had an oxygen saturation of 85% on rst medical contact. The chest radiography and the baseline ECG showed respectively multifocal bilateral patchy opacities and a sinus tachycardia with low QRS voltage and t wave inversion in all leads. On further assessment, the echocardiography revealed the presence of free-oating microthrombi in the right atrium and a moderate pericardial effusion. Biological ndings and pulmonary computed tomography were suggestive of sarscov2 infection. Interestingly, there was no evidence of pulmonary embolism. The patient, thus, received heparin therapy and colchicine. We noted a rapid improvement in the following seven days, the hospital discharge was, hence, deemed warranted. Conclusions: This case highlights an unusual presentation of COVID-19 infection, the diagnostic and therapeutic challenges we are facing in this setting. Moreover, it raises the question about the emergent need of a therapeutic regimen, in order to better manage this unique condition and a fortiori mitigate the COVID-19 complications.
Scimitar syndrome or Felsons veno-lobar syndrome is a very rare congenital disease characterized by a combination of cardiopulmonary abnormalities, including partial right-sided pulmonary venous drainage to the inferior vena cava, the inferior cavo-atrial junction, or low on the right atrium. We report the case of a 53-year-old female patient who presented with recent gradually worsening dyspnea. The diagnosis was suspected on the chest x-ray and confirmed on Cardiac echography andComputed Tomography scan that showed a wide collector gathering the three right superior pulmonary veins that joins the lower part of the superior vena cava, thus joining the right atrium while the right inferior pulmonary vein is drained into the inferior vena cava. The patient was treated surgically by performing a derivation of the right superior pulmonary venous collector to the left atrium with a tricuspid annuloplasty with a good outcome.
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