Taponamiento cardíaco y miocarditis en paciente con infección aguda por SARS-CoV-2 / Cardiac tamponade and myocarditis in a patient with acute SARS-CoV-2 infection
Medicina (B.Aires)
;
81(6): 1045-1047, ago. 2021. graf
Article
in Spanish
|
LILACS-Express
| LILACS
| ID: biblio-1365099
RESUMEN
Resumen Describimos una paciente con COVID-19, con derrame pericárdico, taponamiento cardíaco y depresión miocárdica grave. Mujer de 51 años, sin enfermedad previa, COVID-19 leve que presentó tres episodios de síncope en domicilio. El electrocardiograma mostró ritmo sinusal, ST de concavidad superior difuso 2 mv; en la tomografía se observó derrame pericárdico y parénquima pulmonar normal. Ingresó a terapia intensiva con shock y requerimiento de asistencia ventilatoria mecánica (AVM). En el ecocardiograma se obser vó derrame pericárdico y taponamiento; se realizó drenaje. El ecocardiograma transesofágico mostró deterioro moderado de función sistólica biventricular; strain longitudinal global -14.2%, Fey estimada 43%; deformación global circunferencial -10.1%. A los 7 días del ingreso, la tomografía reveló infiltrados bilaterales y engrosamiento pericárdico con realce post-contraste y derrame pericárdico leve. El día 12 posterior al ingreso, se suspendió el soporte inotrópico; y la paciente, hemodinámicamente estable, se desvinculó de la AVM.
ABSTRACT
Abstract We describe a patient with COVID-19, with pericardial effusion, cardiac tamponade and severe myocar dial depression. A 51-year-old woman, previously healthy, with mild COVID-19 presented with three episodes of syncope. She was admitted to the emergency room. An electrocardiogram showed sinus rhythm, diffuse superior concavity ST 2 mv; a CT scan showed pericardial effusion, without lung pathological findings. Due to shock, dyspnoea and encephalopathy, the patient was admitted to intensive care, where she received vasopressor support and mechanical ventilation. A bedside ultrasound showed pericardial effusion and tamponade; drainage was performed; transoesophageal ultrasound showed moderate deterioration of biventricular systolic function; global longitudinal strain -14.2%, estimated Fey 43%; global circumferential strain -10.1%. Seven days after admission, CT scan revealed bilateral infiltrates and pericardial thickening with post-contrast enhancement and mild pericardial effusion. On day 12 post admission, inotropic support was discontinued; patient on mechanical ventilation weaning and haemodynamically stable.
Full text:
Available
Index:
LILACS (Americas)
Language:
Spanish
Journal:
Medicina (B.Aires)
Journal subject:
Medicine
Year:
2021
Type:
Article
Affiliation country:
Argentina
Institution/Affiliation country:
Hospital Alemán/AR
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