Acute life-threatening cardiac tamponade in a mechanically ventilated patient with COVID-19 pneumonia

Derveni, Vaia; Kaniaris, Evangelos; Toumpanakis, Dimitris; Potamianou, Efstathia; Ioannidou, Ilianna; Theodoulou, Danai; Kyriakoudi, Anna; Kyriakopoulou, Magda; Pontikis, Konstantinos; Daganou, Maria

doi:10.1016/j.idcr.2020.e00898

Cited by 9 publications

(10 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pericardial analysis of another patient with COVID19-associated polyserositis also detected SARS-CoV-2 in the pericardial fluid [ 48 ]. However, other case reports evaluating pericardial effusions have not found any viral RNA in the pericardial fluid [ 45 , 57 , 58 ].…”

Section: Covid-19 Associated Pericardial Involvementmentioning

confidence: 99%

“…Pericardial effusion develops as a result of various insults to the myocardium or pericardium and has variable clinical presentations. Pericardial tamponade was identified in COVID19 patients with deteriorating renal and respiratory function [56,57]. Pericardial tamponade in the setting of acute pericarditis in COVID19 patients is managed with pericardiocentesis, and occasionally a pericardial window is also required (Table 1).…”

Section: Pericardial Effusion and Tamponadementioning

confidence: 99%

See 1 more Smart Citation

Pericardial Diseases in COVID19: a Contemporary Review

et al. 2021

View full text Add to dashboard Cite

Purpose of Review Coronavirus disease 2019 (COVID19) involves the heart, including pericardium. This article reviews the possible pathophysiological mechanisms in pericardial involvement in COVID19 and pericardial manifestations of COVID19. It also summarizes the patients with pericarditis secondary to COVID19 and outlines the contemporary treatment strategies in this patient population. Recent Findings A high degree of suspicion is required to identify the pericardial involvement in COVID19 patients. It is proposed that an underlying hyperinflammatory reaction in COVID19 leads to pericardial inflammation. Acute pericarditis with or without myocardial involvement is diagnosed on clinical presentation, serum inflammatory markers, electrocardiogram, and echocardiogram. Multimodality imaging may also have an additional diagnostic value. Patients are usually managed medically, but some patients develop a life-threatening pericardial tamponade necessitating pericardial drainage. Summary Pericardial involvement is an important clinical manifestation of COVID19 requiring a proper workup. Timely diagnosis and a specific management plan based on the presentation and concomitant organ involvement usually lead to a complete recovery.

show abstract

Section: Covid-19 Associated Pericardial Involvementmentioning

confidence: 99%

Section: Pericardial Effusion and Tamponadementioning

confidence: 99%

Pericardial Diseases in COVID19: a Contemporary Review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…[51], высокое давление в легочной артерии ассоциировано с более высокой госпитальной летальностью (41,7 % против 8,5 %, p<0,001), при этом наличие дисфункции ПЖ не влияло на госпитальную летальность (17,2 % против 11,7 % p=0,404). Анализ литературы в отношении выпота в перикард у пациентов с COVID-19 показал, что данные патологии описывают в основном отдельные клинические ситуации [52][53][54]. Исследование M. Rodríguez-Santamarta и соавт.…”

Section: результатыunclassified

The value of indicators characterizing the state of the cardiovascular system in assessing the hospital prognosis of COVID-19 patients

et al. 2021

View full text Add to dashboard Cite

Background Heart damage is one of complications of the novel coronavirus infection. Searching for available predictors for in-hospital death and survival that determine the tactic of managing patients with COVID-19, is a challenge of the present time.Aim To determine the role echocardiographic (EchoCG) parameters in evaluation of the in-hospital prognosis for patients with the novel coronavirus infection, COVID-19.Material and methods The study included 158 patients admitted for COVID-19. EchoCG was performed for all patients. The role of left ventricular (LV) ejection fraction (EF) was analyzed in various age groups. EchoCG data were compared with the clinical picture, including the severity of respiratory failure (RF), blood oxygen saturation (SрО2), data of computed tomography (CT) of the lungs, and blood concentration of troponin. Comorbidity was analyzed, and the highest significance of individual pathologies was determined.Results LV EF ≤40 % determined the worst prognosis of patients with COVID-19 (p<0.0001), including the age group older than 70 years (р=0.013). LV EF did not correlate with the degree of lung tissue damage determined by CT upon admission (р=0.54) and over time (р=0.23). The indexes that determined an adverse in-hospital prognosis to a considerable degree were pericardial effusion (p<0.0001) and pulmonary hypertension (p<0.0001). RV end-diastolic dimension and LV end-diastolic volume did not determine the in-hospital mortality and survival. Blood serum concentration of troponin I higher than 165.13 µg/l was an important predictor for in-hospital death with a high degree of significance (р<0.0001). Th degree of RF considerably influenced the in-hospital mortality (р<0.0001). RF severity was associated with LV EF (р=0.024). The SpO2 value determined an adverse immediate prognosis with a high degree of significance (р=0.0009). This parameter weakly correlated with LV EF (r=0.26; p=0.0009). Patients who required artificial ventilation (AV) constituted a group with the worst survival rate (р<0.0001). LV EF was associated with a need for AV with a high degree of significance (р=0.0006). Comorbidities, such as chronic kidney disease, postinfarction cardiosclerosis and oncologic diseases, to the greatest extent determined the risk of fatal outcome.Conclusion EchoCG can be recommended for patients with COVID-19 at the hospital stage to determine the tactics of management and for the in-hospital prognosis.

show abstract

“…There have been several case reports of pericarditis with large pericardial effusion and tamponade requiring therapeutic pericardiocentesis. [ 10 11 12 13 14 ] Analysis of pericardial effusion in all patients were exudative with high LDH and albumin and high fluid LDH: serum LDH ratio > 0.6. [ 10 11 12 13 ] In two patients, the effusion was bloody and exudative.…”

Section: Covid-19 and Myocarditis/pericarditismentioning

confidence: 99%

“…[ 12 13 ] Pericardial fluid was not tested for SARS-CoV-2 as the facility was not available in treating hospital[ 11 12 ] and was negative for SARS-CoV-2 in two patients. [ 13 14 ]…”

Section: Covid-19 and Myocarditis/pericarditismentioning

confidence: 99%