Cardiac tamponade and massive pleural effusion in a young COVID-19-positive adult

COVID-19 has a broad spectrum of cardiac manifestations, and cardiac tamponade leading to cardiogenic shock is a rare presentation. A 30-year-old man with a history of COVID-19-positive, reverse transcription polymerase chain reaction (RT-PCR) done 1 week ago and who was home-quarantined, came to th...

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Bibliographic Details
Published in:BMJ case reports 2021-09, Vol.14 (9), p.e244518
Main Authors: Johny, Dilip, Subramanyam, Kodangala, Baikunje, Nandakishore, Hosmane, Giridhar Belur
Format: Article
Language:English
Subjects:
Antibiotics
Antibodies
Antigens
Case Report
Case reports
Cellular biology
Connective tissue
Coronaviruses
COVID-19
Disease
Dyspnea
Etiology
Hypertension
Lungs
Lymphocytes
Myocarditis
Neutrophils
Pandemics
Patients
Pleural effusion
Proteins
Scleroderma
Severe acute respiratory syndrome coronavirus 2
Thorax
Thromboembolism
Transfer RNA
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Summary:COVID-19 has a broad spectrum of cardiac manifestations, and cardiac tamponade leading to cardiogenic shock is a rare presentation. A 30-year-old man with a history of COVID-19-positive, reverse transcription polymerase chain reaction (RT-PCR) done 1 week ago and who was home-quarantined, came to the emergency department with palpitations, breathlessness and orthopnoea. His ECG showed sinus tachycardia with low-voltage complexes, chest X-ray showed cardiomegaly and left pleural effusion and two-dimensional echocardiography showed large pericardial effusion with features suggestive of cardiac tamponade. He was taken up for emergency pericardiocentesis which showed haemorrhagic pericardial fluid. Intercostal drainage insertion was done for left-sided large pleural effusion. After ruling out all the other causes for haemorrhagic pericardial effusion, the patient was started on colchicine, steroids, ibuprofen and antibiotics to which he responded. Both pericardial and pleural effusions resolved completely on follow-up.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-244518