Cardiac Tamponade Secondary to COVID-19

Dabbagh, Mohammed; Aurora, Lindsey; D'Souza, Penny L; Weinmann, Allison; Bhargava, Puneet; Basir, Mir B.

doi:10.1016/j.jaccas.2020.04.009

Cited by 163 publications

(217 citation statements)

References 9 publications

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“…These associations include documented cases of it causing perimyocarditis, cardiac tamponade, cardiogenic shock, and decompensating heart failure. [ 13 – 15 ] However, regardless of the extend of cardiac-pulmonary organs being affected, the patient may present with no specific signs and symptoms that have relevance to COVID-19 infection. Further complicating the diagnostic workup, false positive, and negative results pertaining to serologic and amplification of nucleic acid techniques for the COVID-19 need to be interpreted in conjunction with clinical speculation while investigating the underlying cause of pericardial involvements.…”

Section: Resultsmentioning

confidence: 99%

Symptomatic pericardial effusion in the setting of asymptomatic COVID-19 infection

et al. 2020

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Rationale: Infection with the severe acute respiratory coronavirus disease 2019 (COVID-19) has been shown to cause multi-organ involvement including cardiopulmonary serosal layers infection and inflammation. As a result, pericarditis and pericardial effusion may occur with or without COVID-19 related respiratory signs. Due to limitations in sensitivity and specificity of current COVID-19 diagnostic studies, cases that trigger high clinical intuition, even with negative serologic and polymerase chain reaction testing results, may necessitate further diagnostic workup to discover the underlying etiology. Patient concerns: Here we present a rare case of pericardial effusion in the setting of asymptomatic COVID-19 infection manifesting with the chief complaint of chest pain. Diagnosis: While undergoing diagnostic workup, the patients first 2 sets of COVID 19 reverse transcription-polymerase chain reaction (RT-PCR) were negative while a latter RT-PCR test, as well as serology, were positive, leading to the diagnosis of COVID-19 reinfection or subacute presentation of viral infection with pericardial effusion. Echocardiogram depicted large circumferential pericardial effusion with mildly thickened pericardium. Interventions: The patient underwent pericardial window placement followed by ibuprofen administration and discharged from the hospital. Outcomes: During the follow-up visit patient had no symptoms and echocardiogram demonstrated complete resolution of the effusion. Lessons: Due to the possible establishment of pericardial effusions and consecutively tamponade even without any COVID-19 related clinical presentation, it is crucial for clinicians to trust their intuition, conduct the appropriate diagnostic tests, find the underlying diagnosis and prevent the devastating consequences.

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Section: Resultsmentioning

confidence: 99%

Symptomatic pericardial effusion in the setting of asymptomatic COVID-19 infection

et al. 2020

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“…Arrhythmias, myocarditis, hypercoagulability, congestive heart failure, and, surprisingly, two cases of cardiac tamponade physiology, both resulting from hemorrhagic pericardial effusion, have been reported. [5][6][7][8] We further report three cases of COVID-19 complicated by cardiac tamponade requiring emergent surgical intervention. He underwent emergent percutaneous drainage of 1500 mL of clear pericardial fluid which was sent for cytology (Table 1) (Table 3).…”

Section: Introductionmentioning

confidence: 87%

Cardiac tamponade in COVID‐19 patients: Management and outcomes

Hakmi

Sohail

Brathwaite

et al. 2020

Journal of Cardiac Surgery

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Importance: Cardiac tamponade requiring emergent intervention is a possible complication of coronavirus disease 2019 (COVID-19) infection. Favorable clinical outcomes are possible if timely management and drainage are performed unless ventricular failure develops. Observation: Cardiac tamponade in COVID-19, based on the limited reported cases, seems to be more common among middle-aged men with observed complications in black and ethnic minorities. Prognosis is worse amongst patients with concomitant ventricular failure. Design and Methods: This is a case series of three COVID-19 patients complicated by cardiac tamponade, requiring surgical intervention at a single institution in New York.

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“…For Takotsubo cardiomyopathy, that might share pathophysiological mechanisms with TGA [5,6], it has been reported that it can occur in the context of natural disasters like e. g. earthquakes [7]; the first cases in the context of Covid-19 have been published recently [8][9][10].…”

mentioning

confidence: 99%