Life-Threatening Cardiac Tamponade Secondary to COVID-19 Treated with Uniportal Video-Assisted Thoracoscopic Surgery: A Case Report

Essa, Rawand Abdulrahman; Ahmed, Sirwan Khalid

doi:10.12659/ajcr.935839

Cited by 3 publications

(2 citation statements)

References 35 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Large pericardial effusions are considered to be a late sequela of COVID-19, presenting within 2-3 weeks of pulmonary symptoms and, in some instances, with undetectable virus on NP/OP samples [16,[20][21][22][23]. Various treatment modalities have been used, including pericardial drainage with or without colchicine [16-18, 21, 22] and uniportal video-assisted thoracoscopic surgery [24]. Similarly, our patient's pericardial effusion was diagnosed after a 2-week history of new-onset cough and dyspnea.…”

Section: Discussionmentioning

confidence: 99%

Detection of SARS-CoV-2 and HHV-8 from a large pericardial effusion in an HIV-positive patient with COVID-19 and clinically diagnosed Kaposi sarcoma: a case report

Yanes¹,

Malijan

Escora-Garcia³

et al. 2022

Trop Med Health

View full text Add to dashboard Cite

Background Pericardial effusion is a late manifestation of HIV more commonly observed in individuals with depressed CD4 counts. Although Mycobacterium tuberculosis remains to be one of the most frequently identified pathogens in the pericardial fluid among people living with HIV, less commonly described etiologies include SARS-CoV-2 that causes coronavirus disease and human herpesvirus-8 which is associated with Kaposi sarcoma. Isolation of more than one pathogen in normally sterile sites remains challenging and rare. We report the first documentation of both SARS-CoV-2 and HHV-8 in the pericardial fluid. Case presentation We present the case of a young man in his 20s with a recent history of clinically diagnosed pulmonary tuberculosis who was admitted for progressive dyspnea and cough. He had multiple violaceous cutaneous lesions on the face, neck, and trunk and diffused lymphadenopathies. He tested positive for SARS-CoV-2 on admission. The patient was clinically diagnosed with pneumonia, Kaposi sarcoma, and HIV/AIDS. Empiric broad spectrum antimicrobial regimen was subsequently initiated. HIV with low CD4 count was confirmed during hospitalization. Echocardiography revealed a large pericardial effusion, in impending cardiac tamponade. Frond-like fibrin strands, extending to the parietal pericardium, were also observed. Pericardiostomy yielded hemorrhagic, exudative effusion with lymphocytic predominance. SARS-CoV-2 and HHV-8 were detected in the pericardial fluid, and bacterial, fungal, and tuberculous studies were negative. The patient had clinical improvement after pericardial drainage. However, despite our best clinical care, he developed a nosocomial infection leading to clinical deterioration and death. Conclusion Detection of SARS-CoV-2 and HHV-8 in the pericardial fluid is rare, and interpretation of their significance in clinical care is challenging. However, coronavirus disease and Kaposi sarcoma must be considered and adequately addressed in immunocompromised adults presenting with large pericardial effusion.

show abstract

Section: Discussionmentioning

confidence: 99%

Detection of SARS-CoV-2 and HHV-8 from a large pericardial effusion in an HIV-positive patient with COVID-19 and clinically diagnosed Kaposi sarcoma: a case report

Yanes¹,

Malijan

Escora-Garcia³

et al. 2022

Trop Med Health

View full text Add to dashboard Cite

show abstract

“…Treatment typically involves either emergent drainage via needle paracentesis or open surgical drainage, especially when a clot is evident [ 6 ]. Studies have shown that in general there is no significant difference in overall mortality between percutaneous pericardiocentesis and open surgical drainage for evacuating symptomatic pericardial effusions and cardiac tamponade [ 7 ]. The decision to proceed with one of these interventions is strictly based on the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Tamponade Causing Predominant Left Atrial and Ventricular Compression After Left Ventricular Assist Device Placement

et al. 2022

View full text Add to dashboard Cite

Patient: Male, 47-year-old Final Diagnosis: Left-sided cardiac tamponade Symptoms: Back pain • dyspnea • hypotension Medication: — Clinical Procedure: — Specialty: Anesthesiology Objective: Unusual clinical course Background: Cardiac tamponade is a life-threatening condition that occurs when pericardial fluid accumulates in the pericardial sac, causing compression of the heart and obstructive shock. This hemodynamic event typically occurs in right-sided cardiac chambers due to the low pressures of the right atrium and right ventricle. Patients undergoing left ventricular assist device (LVAD) placement are at particularly high risk of pericardial effusion development and potential cardiac tamponade because of the need for postoperative anticoagulation. Case Report: A 47-year-old man underwent LVAD placement for deteriorating biventricular function. After several days of stability postoperatively, he experienced dyspnea and had evidence of increasing hemodynamic compromise. He was immediately taken to the operating room, where transesophageal echocardiography showed near-complete collapse of the left atrium and left ventricle with preservation of the right heart chamber sizes in the setting of a large heterogenous posterior pericardial effusion. With swift surgical intervention, the cardiac tamponade was successfully evacuated and the patient regained hemodynamic stability. Conclusions: Cardiac tamponade can present overtly or covertly, and should be high on the list of differential diagnoses in a patient with deterioration in hemodynamic status after cardiac surgery, especially after LVAD placement. Although cardiac tamponade usually affects right-sided cardiac chambers, the left-sided chambers can also be involved. Isolated left-sided cardiac tamponade is rare but can occur in the presence of a loculated posterior pericardial effusion, as seen in this patient.

show abstract

Acute Cardiovascular Complications of COVID-19: A Systematic Review

Tolu-Akinnawo¹,

Poku²,

Elimihele³

et al. 2023

Cureus

View full text Add to dashboard Cite

Since the pandemic in 2019, coronavirus 2019 (COVID-19) has continued to be linked with a variety of organ systems and complications. While it is generally considered a respiratory disease, its link with the heart is widely discussed in the literature. This article focuses on the acute cardiovascular complications of COVID-19 and the possible predictors of these complications. Our study included 97 articles (58 case reports, eight case series, 23 retrospective cohort studies, five prospective cohort studies, and three cross-sectional studies). Several mechanisms have been proposed to explain COVID-19-induced cardiovascular complications, with cytokine-induced inflammation and direct cardiac damage noted as the significant focus. Patients with underlying cardiovascular complications such as hypertension and diabetes were noted to be at increased risk of acute cardiovascular complications, as well as an increased risk of severe disease and death. Also, acute myocardial infarction and arrhythmias were two of the most common acute cardiovascular complications noted in our review. Other acute cardiovascular complications are myocarditis, takotsubo syndrome, acute thromboembolic events, and pericardial complications. This article provides an updated review of acute cardiovascular complications of COVID-19, its pathogenesis, and risk stratification and emphasizes the need for high suspicion in patients with underlying cardiovascular risk factors.

show abstract

Life-Threatening Cardiac Tamponade Secondary to COVID-19 Treated with Uniportal Video-Assisted Thoracoscopic Surgery: A Case Report

Cited by 3 publications

References 35 publications

Detection of SARS-CoV-2 and HHV-8 from a large pericardial effusion in an HIV-positive patient with COVID-19 and clinically diagnosed Kaposi sarcoma: a case report

Detection of SARS-CoV-2 and HHV-8 from a large pericardial effusion in an HIV-positive patient with COVID-19 and clinically diagnosed Kaposi sarcoma: a case report

Cardiac Tamponade Causing Predominant Left Atrial and Ventricular Compression After Left Ventricular Assist Device Placement

Acute Cardiovascular Complications of COVID-19: A Systematic Review

Contact Info

Product

Resources

About