A CASE OF IDIOPATHIC HEMORRHAGIC PERICARDIAL EFFUSION: NO CLUES LEFT BEHIND
Journal of the American College of Cardiology
; 79(9):2694, 2022.
Article
in English
| EMBASE | ID: covidwho-1757979
ABSTRACT
Background:
Hemorrhagic pericardial effusion (HPE) is an infrequently encountered entity. We present here a challenging case of HPE. Case A 67-year-old woman with history of hypothyroidism presented with dyspnea, chest discomfort, chills since 2 weeks. She had received mRNA-1273 vaccine 7 days prior to presentation. Vitals were notable for a heart rate of 136/min, otherwise she was hemodynamically stable. Physical exam was notable for muffled heart sounds. Decision-making Labs showed a hemoglobin of 9.6 g/dL, C reactive protien(CRP) of 93.80 mg/L, normal thyroid profile and troponin, and a negative COVID-19 PCR. ECG was suggestive of sinus tachycardia. An Echocardiogram showed ejection fraction of 55-60% and large pericardial effusion with tamponade physiology. Emergent pericardiocentesis was done, removing 940 mL of sanguineous fluid. Pericardial fluid showed predominantly red blood cells;cytology was negative for malignant cells. Infectious workup for fungal, viral, tuberculosis and bacterial infections, and antibody testing as a part of rheumatologic workup was negative. A CT of the chest, abdomen and pelvis did not show any evidence of malignancy. She remained hemodynamically stable and was discharged on colchicine and ibuprofen. The patient did well on follow up at one month.Conclusion:
Despite extensive workup, underlying etiology of HPE was not identified. As the symptoms preceded vaccination, the likelihood of vaccine-induced pericarditis and HPE was deemed low. [Formula presented]
C reactive protein; colchicine; elasomeran; endogenous compound; hemoglobin; ibuprofen; troponin; abdomen; adverse drug reaction; aged; bacterial infection; cancer cell; case report; chill; clinical article; conference abstract; coronavirus disease 2019; cytology; decision making; dyspnea; echocardiography; electrocardiogram; electrocardiography; erythrocyte; female; follow up; heart ejection fraction; heart rate; heart sound; human; human cell; hypothyroidism; mycosis; pelvis; pericardial effusion; pericardiocentesis; pericarditis; physical examination; side effect; sinus tachycardia; thorax pain; tuberculosis; vaccination
Full text:
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Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Journal of the American College of Cardiology
Year:
2022
Document Type:
Article
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