Pericardial Effusion and Cardiac Tamponade Requiring Pericardial Window in an Otherwise Healthy 30-year-old Patient With COVID-19

A Case Report

Christina Walker; Vincent Peyko; Charles Farrell; Jeanine Awad-Spirtos; Matthew Adamo; John Scrocco

Disclosures

J Med Case Reports. 2020;14(158) 

In This Article

Abstract and Introduction

Abstract

Background: This case report demonstrates pericardial effusion, acute pericarditis, and cardiac tamponade in an otherwise healthy woman who had a positive test result for coronavirus disease 2019. Few case reports have been documented on patients with this presentation, and it is important to share novel presentations of the disease as they are discovered.

Case Presentation: A Caucasian patient with coronavirus disease 2019 returned to the emergency department of our hospital 2 days after her initial visit with worsening chest pain and shortness of breath. Imaging revealed new pericardial effusion since the previous visit. The patient became hypotensive, was taken for pericardial window for cardiac tamponade with a drain placed, and was treated for acute pericarditis.

Conclusion: Much is still unknown about the implications of coronavirus disease 2019. With the novel coronavirus disease 2019 pandemic, research is still in process, and we are slowly learning about new signs and symptoms of the disease. This case report documents a lesser-known presentation of a patient with coronavirus disease 2019 and will help to further understanding of a rare presentation.

Introduction

Acute pericarditis, pericardial effusion, and cardiac tamponade should be considered in patients presenting with chest pain who have suspected or proven coronavirus disease 2019 (COVID-19). Clinicians should broaden their differential diagnoses when evaluating these patients and use ultrasound early to help guide the diagnosis. Early diagnosis and treatment will likely prevent complications associated with acute pericarditis.

As more information is gathered in relation to COVID-19, the medical community will have a better understanding of the numerous clinical manifestations of the disease. For now, we must take into account various presentations, common and uncommon, related through case reports such as the present one and many others.

The goal of this report is to review and improve understanding of an uncommon complication associated with COVID-19. Additionally, one must maintain a wide differential diagnosis at all times, particularly when there is a tendency to focus on lung pathology while considering complications of COVID-19.

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