Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge

Asif, Talal; Kassab, Kameel; Iskander, Fady; Alyousef, Tareq

doi:10.12890/2020_001701

Cited by 33 publications

(20 citation statements)

References 10 publications

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“…Pericarditis has been noted to be a rare presenting symptom of COVID-19, occurring at the time of or shortly after diagnosis [12][13][14]. Pericarditis and myocarditis presentations associated with positive COVID-19 PCR testing have ranged in reported acuity from mild symptoms to lethal tamponade.…”

Section: Discussionmentioning

confidence: 99%

“…This case is notable in its subtle presentation, EKG and echocardiogram findings, which required multiple evaluations prior to definitive diagnosis. Early diagnosis of pericarditis is essential as it is known complications include constrictive pericarditis and cardiac tamponade, with life-threatening presentations previously described in the setting of COVID-19 [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…Pericarditis is a rare extrapulmonary complication of COVID-19 infection and has been described in only a handful of cases [12][13][14]. However, these cases describe pericarditis diagnosed within one week of the initial diagnosis of COVID-19 infection and with emergent intervention required to stabilize tamponade physiology.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Delayed Case of Pericarditis Following Recovery From COVID-19 Infection

Kaminski¹,

Albus²,

Mohseni³

et al. 2021

Cureus

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Delayed Case of Pericarditis Following Recovery From COVID-19 Infection

Kaminski¹,

Albus²,

Mohseni³

et al. 2021

Cureus

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“…Most cases present acutely at the time of diagnosis and up to 2 weeks after the first positive COVID-19 test. 3 7–10 14–19 There are no clear common risk factors for those who developed symptomatic acute pericarditis. Some had cardiovascular disease including recent myocardial infarctions, but many were healthy or had controlled chronic diseases.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Most cases progress to a chronic disease requiring surgical intervention with pericardiectomy—the surgical removal of both the parietal and epicardial layers of the pericardium—as the only definitive treatment. 3 One study found that 17% of CP cases resolved without surgery after about 8 weeks of medical therapy alone. However, most cases progressed to a chronic disease requiring definitive treatment with surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Coronavirus disease 2019 (COVID-19)-associated constrictive pericarditis

et al. 2021

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This report documents a rare case of COVID-19-associated constrictive pericarditis (CP) in the setting of a recent COVID-19 infection. A 55-year-old man with a history of hypertension and gout presented with acute hypoxic respiratory failure and was diagnosed with COVID-19 pneumonia with progression to acute respiratory distress syndrome. His hospital course was complicated by a large pericardial effusion; an emergent bedside transthoracic echocardiography was concerning for cardiac tamponade, so pericardiocentesis was performed. A workup with cardiac magnetic resonance imaging showed changes consistent with a diagnosis of CP. Viral and idiopathic aetiologies are the most common cause of CP in the developed world, with COVID-19 now a proposed predisposing viral illness. The virus induces systemic inflammation and pericardial changes that can lead to CP physiology. Imaging modalities including echocardiogram and cardiac magnetic resonance play an integral role in confirming the diagnosis.

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Pericardial Diseases in COVID19: a Contemporary Review

et al. 2021

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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.

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Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge

Cited by 33 publications

References 10 publications

A Delayed Case of Pericarditis Following Recovery From COVID-19 Infection

A Delayed Case of Pericarditis Following Recovery From COVID-19 Infection

Coronavirus disease 2019 (COVID-19)-associated constrictive pericarditis

Pericardial Diseases in COVID19: a Contemporary Review

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