[Cardiac tamponade and myocarditis in a patient with acute SARS-CoV-2 infection]

ABSTRACT

We describe a patient with COVID-19, with pericardial effusion, cardiac tamponade and severe myocardial 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.