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

2523 91

In Press

08 Jun 2023 : Case report  Latvia

Chylothorax: A Tangled Road to Definitive Diagnosis of Non-Hodgkin Lymphoma

Am J Case Rep In Press; DOI: 10.12659/AJCR.939098  

06 Jun 2023 : Case report  Saudi Arabia

A Classical Case of Cesarean Scar Endometriosis in a 35-Year-Old Woman Presenting with Cyclical Abdominal P...

Am J Case Rep In Press; DOI: 10.12659/AJCR.940200  

05 Jun 2023 : Case report  USA

Peri-Hilar Cystic Lymphangioma Mimicking a Biliary Cystic Lesion Causing Biliary Obstruction: A Case Report...

Am J Case Rep In Press; DOI: 10.12659/AJCR.939421  

05 Jun 2023 : Case report  Palestinian Territory, Occupied

Recurrent Bioprosthetic Valve Serratia marcescens Endocarditis in Intravenous Drug Users

Am J Case Rep In Press; DOI: 10.12659/AJCR.939292  

Most Viewed Current Articles

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

07 Dec 2021 : Case report  USA

Edwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...

DOI :10.12659/AJCR.934347

Am J Case Rep 2021; 22:e934347

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