Symptomatic pericardial effusion in the setting of asymptomatic COVID-19 infection: A case report.
Medicine (Baltimore)
; 99(37): e22093, 2020 Sep 11.
Article
in English
| MEDLINE | ID: covidwho-760047
ABSTRACT
RATIONALE Infection with the severe acute respiratory coronavirus disease 2019 (COVID-19) has been shown to cause multi-organ involvement including cardiopulmonary serosal layers infection and inflammation. As a result, pericarditis and pericardial effusion may occur with or without COVID-19 related respiratory signs. Due to limitations in sensitivity and specificity of current COVID-19 diagnostic studies, cases that trigger high clinical intuition, even with negative serologic and polymerase chain reaction testing results, may necessitate further diagnostic workup to discover the underlying etiology. PATIENT CONCERNS Here we present a rare case of pericardial effusion in the setting of asymptomatic COVID-19 infection manifesting with the chief complaint of chest pain. DIAGNOSIS While undergoing diagnostic workup, the patients first 2 sets of COVID 19 reverse transcription-polymerase chain reaction (RT-PCR) were negative while a latter RT-PCR test, as well as serology, were positive, leading to the diagnosis of COVID-19 reinfection or subacute presentation of viral infection with pericardial effusion. Echocardiogram depicted large circumferential pericardial effusion with mildly thickened pericardium. INTERVENTIONS:
The patient underwent pericardial window placement followed by ibuprofen administration and discharged from the hospital.OUTCOMES:
During the follow-up visit patient had no symptoms and echocardiogram demonstrated complete resolution of the effusion. LESSONS Due to the possible establishment of pericardial effusions and consecutively tamponade even without any COVID-19 related clinical presentation, it is crucial for clinicians to trust their intuition, conduct the appropriate diagnostic tests, find the underlying diagnosis and prevent the devastating consequences.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pericardial Effusion
/
Pneumonia, Viral
/
Echocardiography
/
Coronavirus Infections
/
Pericardiocentesis
/
Pandemics
/
Betacoronavirus
Type of study:
Case report
/
Cohort study
/
Diagnostic study
/
Etiology study
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Medicine (Baltimore)
Year:
2020
Document Type:
Article
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