COVID-19 myopericarditis with cardiac tamponade in the absence of respiratory symptoms: a case report

Abstract

Background Previous reports have shown various cardiac complications to be associated with COVID-19 including: myocardial infarction, microembolic complications, myocardial injury, arrythmia, heart failure, coronary vasospasm, non-ischemic cardiomyopathy, stress (Takotsubo) cardiomyopathy, pericarditis and myocarditis. These COVID-19 cardiac complications were associated with respiratory symptoms. However, our case illustrates that COVID-19 myopericarditis with cardiac tamponade can present without respiratory symptoms. Case presentation A 58-year-old Caucasian British woman was admitted with fever, diarrhoea and vomiting. She developed cardiogenic shock and Transthoracic echocardiogram (TTE) found a pericardial effusion with evidence of cardiac tamponade. A nasopharyngeal swab showed a COVID-19 positive result, despite no respiratory symptoms on presentation. A pericardial drain was inserted and vasopressor support required on intensive treatment unit (ITU). The drain was removed as she improved, an antibiotic course was given and she was discharged on day 12. Conclusions Our case demonstrates that patients without respiratory symptoms could have COVID-19 and develop cardiac complications. These findings can aid timely diagnosis of potentially life-threatening COVID-19 myopericarditis with cardiac tamponade.

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

“…Another myopericarditis case with large pericardial effusion and tamponade in patients with COVID-19 has been reported by Sauer et al too 4 . However, in comparison, Cairns et al reported an acute myopericarditis and pericardial effusion case, even in the absence of respiratory symptoms 19 .…”

COVID-19 and myocarditis: a brief review

“…Thirty two case reports describing a total of thirty three cases that document myocarditis/myopericarditis attributed to COVID-19 infection reported from July 1, 2020 to May 29, 2021 [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Occurrence of myocarditis related to COVID-19 in males was higher than females (72.7%), and the median age of the reported cases was 49 years.…”

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

“…COVID-19 causes numerous cardiovascular complications including arrhythmia, myocarditis, acute myocardial injury, cardiogenic shock, and thromboembolism [ 12 , 13 ]. However, cardiac tamponade has rarely been reported as a COVID-19 complication [ 12 – 14 ].…”

“…Pericardial effusion was reported in 4.55% of 2738 patients with COVID-19 [ 15 ]. To date, only a few cases of pericardial effusion causing cardiac tamponade in patients with COVID-19 have been reported in the literature, and all of them were treated by pericardiocentesis, colchicine, pericardial window, aspirin, ibuprofen, steroids, and antiviral drugs [ 9 , 14 , 16 – 33 ]. Conversely, our case report demonstrates the first case treated by u-VATS.…”