Elsevier

IDCases

Volume 21, 2020, e00898
IDCases

Case report
Acute life-threatening cardiac tamponade in a mechanically ventilated patient with COVID-19 pneumonia

https://doi.org/10.1016/j.idcr.2020.e00898Get rights and content
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open access

Highlights

  • Pericardial effusion with acute cardiac tamponade may be a potential complication of severe SARS-CoV-2 infection.

  • This should be kept in mind especially when facing mechanically ventilated patients with acute hemodynamic collapse.

  • Bedside TTE is a valuable tool for prompt diagnosis and life-saving therapeutic pericardiocentesis.

Abstract

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has recently evolved as a pandemic disease. Although the respiratory system is predominantly affected, cardiovascular complications have been frequently identified, including acute myocarditis, myocardial infarction, acute heart failure, arrhythmias and venous thromboembolic events. Pericardial disease has been rarely reported. We present a case of acute life-threatening cardiac tamponade caused by a small pericardial effusion in a mechanically ventilated patient with severe COVID-19 associated pneumonia. The patient presented acute circulatory collapse with hemodynamic features of cardiogenic or obstructive shock. Bedside echocardiography permitted prompt diagnosis and life-saving pericardiocentesis. Further investigation revealed no other apparent cause of pericardial effusion except for SARS-CoV-2 infection. Cardiac tamponade may complicate COVID-19 and should be included in the differential diagnosis of acute hemodynamic deterioration in mechanically ventilated COVID-19 patients.

Keywords

COVID-19
Pericardial effusion
Cardiac tamponade
Shock

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