ABSTRACT
COVID-19 has been associated with significant risk for cardiac arrhythmias, particularly in patients with underlying cardiac conditions or prior histories of arrhythmia. It has been shown that a Brugada pattern can be unmasked in febrile patients with COVID-19. Herein we report a unique case of an afebrile patient without known prior history of Brugada presenting with Brugada pattern on ECG.
Subject(s)
Brugada Syndrome , COVID-19 , Arrhythmias, Cardiac , Brugada Syndrome/complications , Brugada Syndrome/diagnosis , Electrocardiography , Humans , SARS-CoV-2ABSTRACT
This report documents a rare case of COVID-19-associated constrictive pericarditis (CP) in the setting of a recent COVID-19 infection. A 55-year-old man with a history of hypertension and gout presented with acute hypoxic respiratory failure and was diagnosed with COVID-19 pneumonia with progression to acute respiratory distress syndrome. His hospital course was complicated by a large pericardial effusion; an emergent bedside transthoracic echocardiography was concerning for cardiac tamponade, so pericardiocentesis was performed. A workup with cardiac magnetic resonance imaging showed changes consistent with a diagnosis of CP. Viral and idiopathic aetiologies are the most common cause of CP in the developed world, with COVID-19 now a proposed predisposing viral illness. The virus induces systemic inflammation and pericardial changes that can lead to CP physiology. Imaging modalities including echocardiogram and cardiac magnetic resonance play an integral role in confirming the diagnosis.