Acute Pericarditis and Pericardial Effusion in a Hypertensive COVID-19 Patient

Naqvi, Syeda; Naseeb, Uzma; Fatima, Kainat; Riffat, Sumaira; Memon, Aisha

doi:10.7759/cureus.10705

Cited by 8 publications

(23 citation statements)

References 7 publications

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“…This patient had not been evidenced of interstitial pulmonary disease, pneumonia, and myocardial injury 20 . Similar COVID-19 pericarditis and cardiac tamponade without respiratory symptoms have been reported by Naqvi et al, too 21 . Another similar condition was reported by Sauer et al their patient presented with pleuritic chest pain, dyspnea, and large pericardial effusion.…”

Section: Review Of Literaturesupporting

confidence: 81%

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Coronavirus Disease 2019 (COVID-19) and Severe Pericardial Effusion: From Pathogenesis to Management: A Case Report Based Systematic Review

Kermani-Alghoraishi

Pouramini

Kafi

et al. 2022

Current Problems in Cardiology

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The Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) created a global pandemic that continues to this day. In addition to pulmonary symptoms, the virus can have destructive effects on other organs, especially the heart. For example, large pericardial effusion has been observed as a critical and life-threatening finding in Coronavirus disease of 2019 (COVID-19) patients. In this case report based systematic review, we review the reports of moderate to severe pericardial effusion associated with tamponade physiology. Direct cardiomyocyte and pericardium invasion, inflammation and cytokine storms and oxidative stress due to acute respiratory distress syndrome (ARDS), are the pathogenesis of this phenomenon. The results showed that the manifestations of this finding are variable. Pericardial effusion can be seen as a delayed complication, accompanied by myocarditis or pericarditis, isolated, or with ARDS. In most patients, emergency percutaneous pericardiocentesis was performed, and fluid analysis was often exudative in three pattern of hemorrhagic, serous, and serosanguinous. Medical treatment and follow-up are recommended, especially in cases of pericarditis.

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Section: Review Of Literaturesupporting

confidence: 81%

“…On physical examination, raised JVP, tachycardia, tachypnea, hypotension, pulsus paradoxus, muffled heart sound, and pericardial friction rub can be the signs of significant pericardial effusion with or without pericarditis and myocarditis 7 , 21 , 31 .…”

Section: Review Of Literaturementioning

confidence: 99%

Coronavirus Disease 2019 (COVID-19) and Severe Pericardial Effusion: From Pathogenesis to Management: A Case Report Based Systematic Review

Kermani-Alghoraishi

Pouramini

Kafi

et al. 2022

Current Problems in Cardiology

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“…Medications that have been employed so far in pericardial disease related to COVID-19 include colchicine, NSAIDs including aspirin, steroids, and intravenous immunoglobulins (IVIG) [ 6 , 7 , 17 ]. Colchicine has been used alone or in combination with NSAIDs successfully [ 5 , 7 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hence, it is not unreasonable to continue to choose NSAIDs along with colchicine and avoid steroids for treating pericardial disease related to COVID-19 infection. Invasive interventions include pericardiocentesis more often than pericardiectomy [ 6 - 11 ].…”

Section: Discussionmentioning

confidence: 99%

Challenges in Managing Pericardial Disease Related to Post Viral Syndrome After COVID-19 Infection

Sollie¹,

Vallepu²,

Jagadeesan³

et al. 2021

Cureus

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Although primarily a respiratory illness, coronavirus disease 2019 (COVID-19) has been associated with cardiac involvement with reported cases of myocardial ischemia, arrhythmia, myocarditis, pericarditis, and pericardial effusion leading to cardiac tamponade. Most cases of pericardial disease in this setting have been during the acute infection. Here, we present a patient who developed pericarditis leading to cardiac tamponade after the resolution of the acute COVID-19 infection. Her course of illness was further complicated by poor response to initial medical therapy with non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine which could possibly be related to early exposure to steroids. It is often difficult to establish an underlying etiology for acute pericarditis. Similarly, in our case, although there is no definitive test to prove the causal relationship, this effusion is highly suspicious of being secondary to post viral sequelae after COVID-19 infection when considering the clinical course. It is important to consider pericardial disease as a late complication of COVID-19 even after apparent resolution of the acute infection and be mindful of the therapeutic challenges that we might face while managing such patients.

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“…In total, 29 articles selected for this study were case reports [9][10][11][12][13][14][15][17][18][19][20][22][23][24][25][26][27][28][29][30][31][32][33][34][35][38][39][40][41] while four were case series [16,21,36,37]. All articles were published in 2020 [9][10][11]13,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]…”

Section: Study Characteristicsmentioning

confidence: 99%

A Systematic Review of COVID-19 and Pericarditis

Kariyanna¹,

Ahmed²,

Sutarjono³

et al. 2022

Cureus

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Coronavirus disease 2019 , caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China in December 2019. Since then, the disease has spread globally, leading to the ongoing pandemic. It can cause severe respiratory illness; however, many cases of pericarditis have also been reported. This systematic review aims to recognize the clinical features of pericarditis and myopericarditis in COVID-19 patients.Google Scholar, Medline/PubMed, CINAHL, Cochrane Central, and Web of Science databases were searched for studies reporting "Coronavirus" or "COVID" and "Peri-myocarditis," "heart," or "retrospective." Case reports and retrospective studies published from May 2020 to February 2021 were reviewed.In total, 33 studies on pericarditis, myopericarditis, and pericardial infusion were included in this review. COVID-19 pericarditis affected adult patients at any age. The incidence is more common in males, with a male-to-female ratio of 2:1. Chest pain (60%), fever (51%), and shortness of breath (51%) were the most reported symptoms, followed by cough (39%), fatigue (15%), myalgia (12%), and diarrhea (12%). Laboratory tests revealed leukocytosis with neutrophil predominance, elevated D-dimer, erythrocyte rate, and Creactive protein. Cardiac markers including troponin-1, troponin-T, and brain natriuretic peptide were elevated in most cases. Radiographic imaging of the chest were mostly normal, and only 31% of chest X-rays showed cardiomegaly and or bilateral infiltration. Electrocardiography (ECG) demonstrated normal sinus rhythm with around 59% ST elevation and rarely PR depression or T wave inversion, while the predominant echocardiographic feature was pericardial effusion. Management with colchicine was favored in most cases, followed by non-steroidal anti-inflammatory drugs (NSAIDs), and interventional therapy was only needed when patient developed cardiac tamponade. The majority of the reviewed studies reported either recovery or no continued clinical deterioration.The prevalence of COVID-19-related cardiac diseases is high, and pericarditis is a known extrapulmonary manifestation. However, pericardial effusion and cardiac tamponade are less prevalent and may require urgent intervention to prevent mortality. Pericarditis should be considered in patients with chest pain, ST elevation on ECG, a normal coronary angiogram, and COVID-19. We emphasize the importance of clinical examination, ECG, and echocardiogram for decision-making, and NSAIDs, colchicine, and corticosteroids are considered to be safe in the treatment of pericarditis/myopericarditis associated with COVID-19.

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Acute Pericarditis and Pericardial Effusion in a Hypertensive COVID-19 Patient

Cited by 8 publications

References 7 publications

Coronavirus Disease 2019 (COVID-19) and Severe Pericardial Effusion: From Pathogenesis to Management: A Case Report Based Systematic Review

Coronavirus Disease 2019 (COVID-19) and Severe Pericardial Effusion: From Pathogenesis to Management: A Case Report Based Systematic Review

Challenges in Managing Pericardial Disease Related to Post Viral Syndrome After COVID-19 Infection

A Systematic Review of COVID-19 and Pericarditis

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