Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

01 July 2020 : Case report  USA

Acute Myopericarditis with Pericardial Effusion and Cardiac Tamponade in a Patient with COVID-19

Challenging differential diagnosis

Richa Purohit1AEF, Arjun Kanwal1AE, Anil Pandit2E, Bhavin M. Patel2E, Glenn Robert Meininger23E, Jeffrey Jay Brown2E, Antony George Kaliyadan3E, Aditya Saini234AE*

DOI: 10.12659/AJCR.925554

Am J Case Rep 2020; 21:e925554

Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) is primarily a respiratory illness. However, with rising numbers of cases, multiple reports of cardiovascular manifestations have emerged. We present a case of COVID-19 infection complicated by myopericarditis and tamponade requiring drainage.

CASE REPORT: An 82-year-old woman with multiple comorbidities presented with five days of productive cough, fever with chills, and intermittent diarrhea. She tested positive for COVID-19. Index EKG revealed new diffuse T-wave inversions and a prolonged QT interval (>500 ms). Troponin was mildly elevated without any anginal symptoms. Hydroxychloroquine and azithromycin were not initiated due to concerns about QT prolongation. The echocardiogram revealed preserved left ventricular (LV) function, a small global pericardial effusion, and apical hypokinesis. Serial echocardiograms revealed an enlarging circumferential pericardial effusion with pacemaker wire reported as ‘piercing’ the right ventricular (RV) apex alongside early diastolic collapse of the right ventricle, suggesting echocardiographic tamponade. Chest CT revealed extension of the RV pacemaker lead into the pericardial fat. Interestingly, on comparison with a previous chest CT from 2019, similar lead positions were confirmed. Pericardiocentesis was performed with removal of 400 cc exudate.

CONCLUSIONS: Acute myopericarditis and pericardial effusion can occur in COVID-19 infection, even in the absence of severe pulmonary disease. This case highlights the importance of awareness of rare cardiac manifestations of COVID-19 in the form of acute myopericarditis and cardiac tamponade and their early diagnosis and management.

Keywords: Cardiac Tamponade, COVID-19, myocarditis, Pericarditis, Aged, 80 and over, Betacoronavirus, Early Diagnosis, Echocardiography, Pericardial Effusion, Pericardiocentesis, SARS-CoV-2, Ventricular Function, Left

Add Comment 0 Comments

In Press

03 Apr 2024 : Case report  Jordan

A Rare Case of Congenital Nephrogenic Diabetes Insipidus Associated with Aquaporin 2 Gene Mutation and Subs...

Am J Case Rep In Press; DOI: 10.12659/AJCR.943597  

03 Apr 2024 : Case report  USA

Epigastric Pain and Dysphagia in a 36-Year-Old Man Due to Primary Esophageal Small Cell Carcinoma

Am J Case Rep In Press; DOI: 10.12659/AJCR.943392  

04 Apr 2024 : Case report  China (mainland)

Duodenal Soft Tissue Sarcoma with GLI1 Gene Rearrangement: A Case Report and Literature Review

Am J Case Rep In Press; DOI: 10.12659/AJCR.943271  

05 Apr 2024 : Case report  Colombia

Relationship Between Brugada Syndrome and Ischemic Stroke: A Case Report and Comprehensive Literature Review

Am J Case Rep In Press; DOI: 10.12659/AJCR.943506  

Most Viewed Current Articles

07 Mar 2024 : Case report  USA

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

10 Jan 2022 : Case report  Germany

A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...

DOI :10.12659/AJCR.935263

Am J Case Rep 2022; 23:e935263

19 Jul 2022 : Case report  Saudi Arabia

Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19

DOI :10.12659/AJCR.936128

Am J Case Rep 2022; 23:e936128

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923