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McBenedict B, Ahmed YA, Reda Elmahdi R, Yusuf WH, Netto JGM, Valentim G, Abrahão A, Lima Pessôa B, Mesquita ET. Pericardial Diseases Mortality Trends in Brazil From 2000 to 2022. Cureus 2024; 16:e57949. [PMID: 38738132 PMCID: PMC11084855 DOI: 10.7759/cureus.57949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/10/2024] [Indexed: 05/14/2024] Open
Abstract
Background Pericardial diseases manifest in various clinical forms, including acute pericarditis, constrictive pericarditis, pericardial effusion, and cardiac tamponade, with acute pericarditis being the most prevalent. These conditions significantly contribute to mortality rates. Therefore, this article aimed to analyze mortality trends in the Brazilian population based on age and sex, shedding light on the impact of pericardial diseases on public health outcomes. Methods This is a retrospective time-series analysis of pericardial disease mortality rates in Brazil (2000-2022). Data was obtained from the Department of Informatics of the Unified Health System (DATASUS), and the 10th edition of the International Classification of Diseases (ICD-10) codes: I30, I31, and I32 were included for analysis. We gathered population and demographic data categorized by age range and sex from the Brazilian Institute of Geography and Statistics (IBGE). Subsequently, we computed the age-standardized mortality rate per 100,000 individuals and assessed the annual percentage changes (APCs) and average annual percentage changes (AAPCs) using joinpoint regression, along with their corresponding 95% confidence intervals (CIs). Results In terms of mortality trends based on sex, overall mortality rates remained stable for males and combined sexes over the study period. However, there was a notable increase in mortality rates among females (AAPC=1.18), particularly between 2020 and 2022, with a significant APC of 27.55. Analyzing pericardial diseases across different age groups (20 to 80 years and above), it wasobserved that mortality rates significantly increased in the 70-79 and 80 years and above age groups throughout the study period (AAPC=1.0339 and AAPC=3.4587, respectively). These two age groups experienced the highest significant rise in mortality between 2020 and 2022. Other age groups did not exhibit a significant change in AAPC. Conclusions This comprehensive analysis spanning two decades (2000-2022), examined the mortality trends of pericardial diseases in Brazil and revealed relative stability overall. Males exhibited an overall higher mortality number due to pericardial diseases; however, females showed the most significant increase in mortality trend throughout the whole period. In the first segment (2000-2015), mortality rose across all cohorts, which was attributed to substandard healthcare facilities and infectious diseases like tuberculosis. The second segment (2016-2020) saw a decline in mortality, likely due to improved healthcare, particularly the increased availability of echocardiograms. However, the third segment (2020-2022) witnessed a sharp rise in mortality, coinciding with the COVID-19 pandemic, with post-COVID-19 symptoms, particularly pericarditis. Pericarditis-related death rates declined compared to pericardial effusion, and mortality rates correlated directly with age, with older cohorts experiencing higher mortality due to increased comorbidities, and decline in health and immunocompetency.
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Affiliation(s)
| | | | | | | | | | | | - Ana Abrahão
- Public Health, Fluminense Federal University, Niterói, BRA
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2
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Singh I, Swisher J, Gidda H, Nashed B, Rodriguez D. Acute Viral Pericarditis Complicated by Cardiac Tamponade as a Result of COVID-19. Cureus 2023; 15:e36695. [PMID: 37113373 PMCID: PMC10127944 DOI: 10.7759/cureus.36695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 03/28/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) and coronavirus disease 2019 (COVID-19) predominantly cause respiratory symptoms but cardiovascular complications from COVID-19 have been documented in the literature. Acute pericarditis has been known to be caused by COVID-19 but severe cardiac complications, such as cardiac tamponade, have rarely been reported. Early diagnosis and treatment with pericardiocentesis are imperative, as this can improve patient outcomes. A 56-year-old female presented with chest pain and recurrent episodes of presyncope. The patient tested positive for SARS-Cov-2 through a polymerase chain reaction (PCR) test. The patient was hypotensive on arrival and the initial workup with electrocardiogram was significant for sinus tachycardia with low voltage QRS complexes in the precordial and limb leads. A transthoracic echocardiogram was also done and showed a large circumferential pericardial effusion with chamber collapse of the right atrium and right ventricle during diastole indicative of tamponade physiology. The patient's clinical course was complicated by pulseless electrical activity cardiac arrest during which a pericardiocentesis was done. One hundred (100) mL of serous pericardial fluid was drained and a return of spontaneous circulation was obtained after roughly 10 minutes of cardiopulmonary resuscitation. Further infectious and noninfectious workups, including malignant and rheumatologic etiologies for acute pericarditis, were negative. The patient was subsequently treated with high-dose non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine for viral pericarditis. The patient's clinical course improved, and the patient was subsequently discharged after a prolonged hospital course to a subacute rehabilitation facility to undergo physical therapy.
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Patel NT, Shah MS, Amrithphale A. Potential Cardiac Tamponade Development Secondary to SARS-CoV-2 Infection. Curr Probl Cardiol 2022; 48:101417. [PMID: 36155201 PMCID: PMC9494860 DOI: 10.1016/j.cpcardiol.2022.101417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 11/12/2022]
Abstract
Upon initial discovery in late 2019, severe acute respiratory syndrome coronavirus 2, SARS-CoV-2, has managed to spread across the planet. A plethora of symptoms affecting multiple organ systems have been described, with the most common being nonspecific upper respiratory symptoms: cough, dyspnea, and wheezing. However, the cardiovascular system is also at risk following COVID-19 infection. Numerous cardiovascular complications have been reported by physicians globally, in particular cardiac tamponade Physicians must hold a high index of suspicion in identifying and treating patients with cardiac tamponade who may have contracted the novel coronavirus. This review will describe the current epidemiology and pathophysiology of SARS-CoV-2 and cardiac tamponade, highlighting their clinical course progression and the implications it may have for the severity of both illnesses. The paper will also review published case reports of cardiac tamponade, clinical presentation, and treatment of this complication, as well as the disease as a whole.
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Affiliation(s)
- Neal T Patel
- Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, Florida, U.S.A..
| | - Miti S Shah
- Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, Florida, U.S.A
| | - Amod Amrithphale
- Division of Cardiology, Department of Internal Medicine, University of South Alabama College of Medicine, Mobile, Alabama, U.S.A
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Kumar NR, Patel S, Norwood B. Subacute Cardiac Tamponade in a COVID-19 Patient Despite Negative Testing. Cureus 2022; 14:e29090. [PMID: 36249624 PMCID: PMC9556279 DOI: 10.7759/cureus.29090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 12/02/2022] Open
Abstract
COVID-19 infection has been documented to cause a wide range of symptoms including cardiac complications. We present a case of subacute cardiac tamponade in a patient infected with COVID-19 in the absence of respiratory symptoms; we also review the current literature on this rare sequela. Our patient is a 67-year-old man who presented to the hospital due to intermittent chest pain for three weeks. COVID-19 polymerase chain reaction (PCR) testing was negative two times. He had an outpatient echocardiogram that showed a moderate pericardial effusion about a week prior to the hospital presentation. On admission, a repeat echocardiogram showed a large pericardial effusion with tamponade physiology. Pericardiocentesis did not reveal a clear etiology of the hemorrhagic effusion but four days later, the patient was found to be positive for COVID-19 infection without any clear respiratory illness. Given the absence of other etiology and negative workup, cardiac tamponade was attributed to pericardial inflammation from this virus and our patient improved with colchicine and steroids. We, therefore, advise providers to consider COVID-19 as a cause of hemorrhagic, cryptogenic cardiac tamponade despite negative COVID-19 testing. We also review 42 additional reported cases of cardiac tamponade in patients infected with COVID-19. COVID-19 can cause cardiac tamponade even in the absence of pulmonary disease. This case and literature review highlight tamponade as a rare complication of COVID-19 and should be considered in the differential of any acute deterioration in this patient population.
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Theetha Kariyanna P, Sabih A, Sutarjono B, Shah K, Vargas Peláez A, Lewis J, Yu R, Grewal ES, Jayarangaiah A, Das S, Jayarangaiah A. A Systematic Review of COVID-19 and Pericarditis. Cureus 2022; 14:e27948. [PMID: 36120210 PMCID: PMC9464705 DOI: 10.7759/cureus.27948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China in December 2019. Since then, the disease has spread globally, leading to the ongoing pandemic. It can cause severe respiratory illness; however, many cases of pericarditis have also been reported. This systematic review aims to recognize the clinical features of pericarditis and myopericarditis in COVID-19 patients. Google Scholar, Medline/PubMed, CINAHL, Cochrane Central, and Web of Science databases were searched for studies reporting “Coronavirus” or “COVID” and “Peri-myocarditis,” “heart,” or “retrospective.” Case reports and retrospective studies published from May 2020 to February 2021 were reviewed. In total, 33 studies on pericarditis, myopericarditis, and pericardial infusion were included in this review. COVID-19 pericarditis affected adult patients at any age. The incidence is more common in males, with a male-to-female ratio of 2:1. Chest pain (60%), fever (51%), and shortness of breath (51%) were the most reported symptoms, followed by cough (39%), fatigue (15%), myalgia (12%), and diarrhea (12%). Laboratory tests revealed leukocytosis with neutrophil predominance, elevated D-dimer, erythrocyte rate, and C-reactive protein. Cardiac markers including troponin-1, troponin-T, and brain natriuretic peptide were elevated in most cases. Radiographic imaging of the chest were mostly normal, and only 31% of chest X-rays showed cardiomegaly and or bilateral infiltration. Electrocardiography (ECG) demonstrated normal sinus rhythm with around 59% ST elevation and rarely PR depression or T wave inversion, while the predominant echocardiographic feature was pericardial effusion. Management with colchicine was favored in most cases, followed by non-steroidal anti-inflammatory drugs (NSAIDs), and interventional therapy was only needed when patient developed cardiac tamponade. The majority of the reviewed studies reported either recovery or no continued clinical deterioration. The prevalence of COVID-19-related cardiac diseases is high, and pericarditis is a known extrapulmonary manifestation. However, pericardial effusion and cardiac tamponade are less prevalent and may require urgent intervention to prevent mortality. Pericarditis should be considered in patients with chest pain, ST elevation on ECG, a normal coronary angiogram, and COVID-19. We emphasize the importance of clinical examination, ECG, and echocardiogram for decision-making, and NSAIDs, colchicine, and corticosteroids are considered to be safe in the treatment of pericarditis/myopericarditis associated with COVID-19.
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Khasnavis S, Habib M, Kaawar F, Lee S, Capo A, Atoot A. New Perspectives on Long COVID Syndrome: The Development of Unusually Delayed and Recurring Pericarditis After a Primary SARS-CoV-2 Infection. Cureus 2022; 14:e25559. [PMID: 35784959 PMCID: PMC9247740 DOI: 10.7759/cureus.25559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
Since the start of the COVID-19 pandemic in early 2020, pericarditis has been identified as a COVID-19 complication. We report a case where the development of pericarditis was unusually delayed after the initial COVID infection. The reported onset of pericarditis and pericardial effusion is anywhere from a few days to a few months after infection. Our case surmises that a latent complication of COVID-19 can manifest more than one year after the initial infection. A forty-three-year-old male with a past medical history of SARS-CoV-2 infection in September 2020 presented in September 2021 and January 2022 with recurrent sharp chest pain and shortness of breath. During both admissions, he was diagnosed with acute pericarditis, and his workup was significant for elevations in D-dimer and CRP as well as pericardial and pleural effusions. Recurring pericardial symptoms and persistent elevations in D-dimer and CRP point toward a COVID etiology, particularly in the absence of other factors associated with pericarditis. Our case highlights the importance of recognizing this latent complication one year after the initial infection and how the symptoms can persist beyond the one-year period.
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7
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Amoateng R, Ahmed I, Attah A, Hardman B. Teenager Presenting With Chest Pain and ST-Segment Changes on Electrocardiogram After SARS-CoV-2 Illness: Early Repolarization vs. Acute Pericarditis. Cureus 2022; 14:e24654. [PMID: 35663715 PMCID: PMC9156364 DOI: 10.7759/cureus.24654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2022] [Indexed: 12/15/2022] Open
Abstract
The ST-segment elevation is commonly associated with acute myocardial Infarction. However, there are other non-ischemic causes of ST-elevation. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious illness that continues to plague the world since the first case was reported in China over two years ago. As cases of the diseases become rampant, we have learned more of its complications which can include cardiac and pericardial disease. We present a case report of a young African American male who presented with chest pain six weeks after being diagnosed with SARS-Cov-2 pneumonia. Electrocardiogram (EKG) showed ST-segment changes that were initially presumed to be acute pericarditis. The patient was initially treated with colchicine. After further workup and a second opinion, ST-segment changes were thought to be likely benign early repolarization changes rather than pericarditis. Differential diagnosis of ST-segment changes on EKG in the patient with chest pain is broad. Subtle findings on EKG are important in distinguishing these differentials and should be well known and understood.
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Fadah K, Abolbashari M, Ojha C, Alkhateeb H. Acute Myopericarditis After First Dose of mRNA-1273 SARS-CoV-2 Vaccine in a Young Adult. Cureus 2022; 14:e22111. [PMID: 35308760 PMCID: PMC8918282 DOI: 10.7759/cureus.22111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/05/2022] Open
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Angeli F, Reboldi G, Spanevello A, De Ponti R, Visca D, Marazzato J, Zappa M, Trapasso M, Masnaghetti S, Fabbri LM, Verdecchia P. Electrocardiographic features of patients with COVID-19: One year of unexpected manifestations. Eur J Intern Med 2022; 95:7-12. [PMID: 34670682 PMCID: PMC8514650 DOI: 10.1016/j.ejim.2021.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/07/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Fabio Angeli
- Department of Medicine and Surgery, University of Insubria, Varese, Italy; Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institute, IRCCS Tradate, Italy.
| | - Gianpaolo Reboldi
- Department of Medicine, and Centro di Ricerca Clinica e Traslazionale (CERICLET), University of Perugia, Perugia, Italy
| | - Antonio Spanevello
- Department of Medicine and Surgery, University of Insubria, Varese, Italy; Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institute, IRCCS Tradate, Italy
| | - Roberto De Ponti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Dina Visca
- Department of Medicine and Surgery, University of Insubria, Varese, Italy; Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institute, IRCCS Tradate, Italy
| | - Jacopo Marazzato
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Martina Zappa
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Monica Trapasso
- Dipartimento di Igiene e Prevenzione Sanitaria, PSAL, Sede Territoriale di Varese, ATS Insubria, Varese, Italy
| | - Sergio Masnaghetti
- Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institute, IRCCS Tradate, Italy
| | - Leonardo M Fabbri
- Department of Respiratory and Internal Medicine, University of Modena&Reggio Emilia, Italy
| | - Paolo Verdecchia
- Fondazione Umbra Cuore e Ipertensione-ONLUS, Perugia - Italy and Division of Cardiology, Hospital S. Maria della Misericordia, Perugia, Italy
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10
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Singh A, Nguyen L, Everest S, Shastri P, Alemu RH. Acute Pericarditis Secondary to COVID-19 Infection. Cureus 2021; 13:e20709. [PMID: 35106244 PMCID: PMC8789202 DOI: 10.7759/cureus.20709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2021] [Indexed: 01/19/2023] Open
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cardiac injuries are among the complications caused by COVID-19. This report presents the case of a 25-year-old patient hospitalized due to Coronavirus infection with the complication of recurrent acute pericarditis. The patient was treated with colchicine and high-dose ibuprofen, and the patient was then discharged in stable condition. This report demonstrates an effective treatment plan for acute pericarditis secondary to COVID-19 infection.
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Affiliation(s)
- Arminder Singh
- Internal Medicine, Cape Fear Valley Medical Center, Fayetteville, USA
| | - Lam Nguyen
- School of Medicine, Campbell University School of Osteopathic Medicine, Lillington, USA
| | - Stephanie Everest
- School of Medicine, Campbell University School of Osteopathic Medicine, Lillington, USA
| | - Pinang Shastri
- Cardiology, Cape Fear Valley Medical Center, Fayetteville, USA
| | - Rahel H Alemu
- Cardiology, Cape Fear Valley Medical Center, Fayetteville , USA
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11
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Soewono KY, Raney KC, Sidhu MS. Pericarditis with pericardial effusion as a delayed complication of COVID-19. Proc AMIA Symp 2021; 34:629-630. [PMID: 34456496 DOI: 10.1080/08998280.2021.1918975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) patients typically present with respiratory symptoms; however, cardiac symptoms, such as pericarditis and pericardial effusion, have also been reported. We report a case of acute pericarditis and pericardial effusion as a delayed complication of COVID-19.
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Affiliation(s)
- Kelvin Y Soewono
- Department of Internal Medicine, Methodist Dallas Medical Center, Dallas, Texas
| | - Kenneth C Raney
- Department of Internal Medicine, Methodist Dallas Medical Center, Dallas, Texas
| | - Manavjot S Sidhu
- Division of Cardiology, Methodist Dallas Medical Center, Dallas, Texas
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12
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Diaconu R, Popescu L, Voicu A, Donoiu I. Subacute effusive-constrictive pericarditis in a patient with COVID-19. BMJ Case Rep 2021; 14:14/6/e242443. [PMID: 34116993 PMCID: PMC8201976 DOI: 10.1136/bcr-2021-242443] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We report the case of a previously healthy young woman, who developed a severe form of COVID-19 with massive pneumonia and acute pericarditis in whom constrictive physiology developed rapidly. To our knowledge, this represents the second reported case of SARS-CoV-2 constrictive pericarditis, a rare, but severe cardiac complication.
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Affiliation(s)
- Rodica Diaconu
- Cardiology, Craiova County Emergency Hospital, Craiova, Dolj, Romania
| | - Lucian Popescu
- Cardiology, Craiova County Emergency Hospital, Craiova, Dolj, Romania
| | - Anda Voicu
- Cardiology, Craiova County Emergency Hospital, Craiova, Dolj, Romania
| | - Ionut Donoiu
- Department of Cardiology, Craiova University of Medicine and Pharmacy, Craiova, Romania
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Furqan MM, Verma BR, Cremer PC, Imazio M, Klein AL. Pericardial Diseases in COVID19: a Contemporary Review. Curr Cardiol Rep 2021; 23:90. [PMID: 34081219 PMCID: PMC8173318 DOI: 10.1007/s11886-021-01519-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW Coronavirus disease 2019 (COVID19) involves the heart, including pericardium. This article reviews the possible pathophysiological mechanisms in pericardial involvement in COVID19 and pericardial manifestations of COVID19. It also summarizes the patients with pericarditis secondary to COVID19 and outlines the contemporary treatment strategies in this patient population. RECENT FINDINGS A high degree of suspicion is required to identify the pericardial involvement in COVID19 patients. It is proposed that an underlying hyperinflammatory reaction in COVID19 leads to pericardial inflammation. Acute pericarditis with or without myocardial involvement is diagnosed on clinical presentation, serum inflammatory markers, electrocardiogram, and echocardiogram. Multimodality imaging may also have an additional diagnostic value. Patients are usually managed medically, but some patients develop a life-threatening pericardial tamponade necessitating pericardial drainage. Pericardial involvement is an important clinical manifestation of COVID19 requiring a proper workup. Timely diagnosis and a specific management plan based on the presentation and concomitant organ involvement usually lead to a complete recovery.
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Affiliation(s)
- Muhammad M Furqan
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Beni R Verma
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Paul C Cremer
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Massimo Imazio
- Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), Piazzale Santa Maria della Misericordia 15,, 33100 Udine, Italy
| | - Allan L Klein
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
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Parato VM, Notaristefani C, D'Agostino S, D'Emilio V, Colella S, Kadiyala M, Pierantozzi S, Principi T. COVID-19-Related Pericarditis with Pericardial Clotting as a Hallmark: Two Cases and a Review. J Cardiovasc Echogr 2021; 31:1-5. [PMID: 34221878 PMCID: PMC8230162 DOI: 10.4103/jcecho.jcecho_124_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 12/06/2020] [Indexed: 12/29/2022] Open
Abstract
The prevalence of pericardial effusion and its clinical significance is not well understood in COVID-19 patients. We report two cases of COVID-19-related pericardial effusion complicated by intrapericardial clot formation. The final outcome was favorable, but intrapericardial clot remained mostly unchanged at 6-month follow-up. The treatment approach and the long-term consequences are still unclear. We propose a review of this particular cardiovascular complication in COVID-19 patients.
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Affiliation(s)
- Vito Maurizio Parato
- Emergency Department, Cardiology Unit, ASUR Marche-AV5, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy
| | - Camilla Notaristefani
- Emergency Department, Cardiology Unit, ASUR Marche-AV5, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy
| | - Simone D'Agostino
- Emergency Department, Cardiology Unit, ASUR Marche-AV5, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy
| | - Vittorio D'Emilio
- Pulmonology Unit, ASUR Marche-AV5, Mazzoni Hospital, Ascoli Piceno, Italy
| | - Sara Colella
- Pulmonology Unit, ASUR Marche-AV5, Mazzoni Hospital, Ascoli Piceno, Italy
| | - Madhavi Kadiyala
- School of Medicine, The Heart and Vascular Institute, West Virginia University, Morgantown, WV, USA
| | - Silvia Pierantozzi
- Intensive Care Unit, ASUR Marche-AV5, Madonna del Soccorso Hospital, Morgantown, WV, USA
| | - Tiziana Principi
- Intensive Care Unit, ASUR Marche-AV5, Madonna del Soccorso Hospital, Morgantown, WV, USA
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15
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Beckerman JK, Alarfaj M, Tracy CM, Faiwiszewski AD, Choi AD. Coronavirus disease 2019 (COVID-19)-associated constrictive pericarditis. BMJ Case Rep 2021; 14:14/5/e242018. [PMID: 33975843 PMCID: PMC8117986 DOI: 10.1136/bcr-2021-242018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
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.
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Affiliation(s)
- Jennifer Kate Beckerman
- Department of Internal Medicine, George Washington University School of Medicine, Washington, DC, USA
| | - Mohammad Alarfaj
- Department of Internal Medicine, George Washington University School of Medicine, Washington, DC, USA
| | - Cynthia M Tracy
- Division of Cardiology, George Washington University School of Medicine, Washington, DC, USA
| | - Ariel D Faiwiszewski
- Division of Cardiology, George Washington University School of Medicine, Washington, DC, USA
| | - Andrew D Choi
- Division of Cardiology and Department of Radiology, George Washington University School of Medicine, Washington, DC, USA
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16
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Tashiro Y, Kurihara M, Hori Y, Nakamura Y, Kuarata M, Toshida T, Asano T, Ebato M, Suzuki H, Hashimoto T. CT findings in a patient with Coronavirus Disease-19-associated acute pericarditis. BJR Case Rep 2021; 7:20210001. [PMID: 34131508 PMCID: PMC8171139 DOI: 10.1259/bjrcr.20210001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/12/2021] [Accepted: 03/24/2021] [Indexed: 11/22/2022] Open
Abstract
Coronavirus Disease-19 (COVID-19)-associated acute pericarditis is a rare complication. Several cases have been reported, but those reports have not discussed any imaging findings. Here, we report a case of a 76-year-old female diagnosed with COVID-19-associated pericarditis without pneumonia, and present image findings of the patient's contrast-enhanced CT.
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Affiliation(s)
- Yuki Tashiro
- Department of Radiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Mana Kurihara
- Department of Radiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Yosiro Hori
- Department of Radiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Yuya Nakamura
- Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Masaaki Kuarata
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Tsutomu Toshida
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Taku Asano
- Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Mio Ebato
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Hiroshi Suzuki
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Toshi Hashimoto
- Department of Radiology, Showa University Fujigaoka Hospital, Yokohama, Japan
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17
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Kaminski A, Albus M, Mohseni M, Mirzan H, Harrison MF. A Delayed Case of Pericarditis Following Recovery From COVID-19 Infection. Cureus 2021; 13:e14397. [PMID: 34079649 PMCID: PMC8159345 DOI: 10.7759/cureus.14397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2021] [Indexed: 01/08/2023] Open
Abstract
Pericarditis is a rare cardiac complication of coronavirus 19 (COVID-19) infection. Recent case reports describe severe sequelae of pericarditis, including cardiac tamponade, developing within days of initial COVID-19 symptoms. We present a case of pericarditis with slower onset and milder symptoms, developing over a period of a few weeks in an immunocompetent male who recovered from COVID-19 several months earlier. A 65-year-old male presented to an emergency department several times for one week of worsening chest and neck symptoms, along with fever. He had been symptom-free after a three-day course of cough, myalgias, and fever with positive COVID-19 testing, approximately 70 days earlier. He was ultimately admitted for fever and pericarditis with an associated pericardial effusion and positive PCR testing for COVID-19. Pericarditis should be considered in the differential diagnosis for patients with COVID-19 and unexplained persistent chest symptoms. The possibility of recurrent or atypical latent infection should additionally be considered in the months following the initial COVID-19 infection. Bedside ultrasound may facilitate early diagnosis and management of COVID-19 associated pericarditis.
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Affiliation(s)
- Ann Kaminski
- Emergency Medicine, Mayo Clinic, Jacksonville, USA
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18
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Messina F, Turano L, Tebala C, Calabrese G, Arcadi N. Pericardial and pleural effusion in an elderly woman with Covid-19 pneumonia: CT findings. Radiol Case Rep 2021; 16:1335-1338. [PMID: 33777279 PMCID: PMC7988447 DOI: 10.1016/j.radcr.2021.03.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 03/20/2021] [Accepted: 03/20/2021] [Indexed: 01/19/2023] Open
Abstract
Coronavirus-19 disease is an acute respiratory syndrome infection that primarily infects the lungs, and may extend to other organs such as the cardiovascular system. Here we describe the case of a 90-year-old woman, affected by heart failure (NYHA, class III), with bilateral Covid-19 pneumonia, complicated by pleural and pericardial effusion. An unenhanced Computed Tomography, urgently made, allowed to hospitalize and treat the patient, monitoring her clinical situations.
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Affiliation(s)
- Francesco Messina
- Unit of Radiology - Riuniti Hospital, Azienda Ospedaliera Grande Ospedale Metropolitano (G.O.M.) "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Lorena Turano
- Unit of Radiology - Riuniti Hospital, Azienda Ospedaliera Grande Ospedale Metropolitano (G.O.M.) "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Carmela Tebala
- Unit of Radiology - Riuniti Hospital, Azienda Ospedaliera Grande Ospedale Metropolitano (G.O.M.) "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Grazia Calabrese
- Unit of Radiology - Riuniti Hospital, Azienda Ospedaliera Grande Ospedale Metropolitano (G.O.M.) "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Nicola Arcadi
- Unit of Radiology - Riuniti Hospital, Azienda Ospedaliera Grande Ospedale Metropolitano (G.O.M.) "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
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19
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Catapano F, Marchitelli L, Cundari G, Cilia F, Mancuso G, Pambianchi G, Galea N, Ricci P, Catalano C, Francone M. Role of advanced imaging in COVID-19 cardiovascular complications. Insights Imaging 2021; 12:28. [PMID: 33625637 PMCID: PMC7903405 DOI: 10.1186/s13244-021-00973-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/28/2021] [Indexed: 01/08/2023] Open
Abstract
Clinical manifestations of COVID-19 patients are dominated by respiratory symptoms, but cardiac complications are commonly observed and associated with increased morbidity and mortality. Underlying pathological mechanisms of cardiac injury are still not entirely elucidated, likely depending on a combination of direct viral damage with an uncontrolled immune activation. Cardiac involvement in these patients ranges from a subtle myocardial injury to cardiogenic shock. Advanced cardiac imaging plays a key role in discriminating the broad spectrum of differential diagnoses. Present article aims to review the value of advanced multimodality imaging in patients with suspected SARS-CoV-2-related cardiovascular involvement and its essential role in risk stratification and tailored treatment strategies. Based on our experience, we also sought to suggest possible diagnostic algorithms for the rationale utilization of advanced imaging tools, such as cardiac CT and CMR, avoiding unnecessary examinations and diagnostic delays.
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Affiliation(s)
- Federica Catapano
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Livia Marchitelli
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Giulia Cundari
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Francesco Cilia
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Giuseppe Mancuso
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Giacomo Pambianchi
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Nicola Galea
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Paolo Ricci
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
- Unit of Emergency Radiology, Policlinico Umberto I, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marco Francone
- Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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20
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Sollie ZW, Vallepu SR, Tharumia Jagadeesan C, White LC, Nagalapuram V. Challenges in Managing Pericardial Disease Related to Post Viral Syndrome After COVID-19 Infection. Cureus 2021; 13:e13461. [PMID: 33777550 PMCID: PMC7984891 DOI: 10.7759/cureus.13461] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2021] [Indexed: 12/16/2022] Open
Abstract
Although primarily a respiratory illness, coronavirus disease 2019 (COVID-19) has been associated with cardiac involvement with reported cases of myocardial ischemia, arrhythmia, myocarditis, pericarditis, and pericardial effusion leading to cardiac tamponade. Most cases of pericardial disease in this setting have been during the acute infection. Here, we present a patient who developed pericarditis leading to cardiac tamponade after the resolution of the acute COVID-19 infection. Her course of illness was further complicated by poor response to initial medical therapy with non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine which could possibly be related to early exposure to steroids. It is often difficult to establish an underlying etiology for acute pericarditis. Similarly, in our case, although there is no definitive test to prove the causal relationship, this effusion is highly suspicious of being secondary to post viral sequelae after COVID-19 infection when considering the clinical course. It is important to consider pericardial disease as a late complication of COVID-19 even after apparent resolution of the acute infection and be mindful of the therapeutic challenges that we might face while managing such patients.
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Affiliation(s)
- Zachary W Sollie
- Internal Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, USA
| | - Shirisha R Vallepu
- Internal Medicine, University of Alabama at Birmingham, Montgomery Internal Medicine, Montgomery, USA
| | | | - Lori C White
- Internal Medicine, University of Alabama at Birmingham, Montgomery Internal Medicine, Montgomery, USA
| | - Vishnu Nagalapuram
- Internal Medicine, University of Alabama at Birmingham, Montgomery Internal Medicine, Montgomery, USA
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21
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Robak O, Dudek M, Ladny JR, Szarpak L, Gilis-Malinowska N, Frass M. Cardiac tamponade as a cause of COVID-19. Cardiol J 2021; 27:900-901. [PMID: 33432570 DOI: 10.5603/cj.2020.0175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Oliver Robak
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Maciej Dudek
- Polish Society of Disaster Medicine, Warsaw, Poland
| | - Jerzy R Ladny
- Polish Society of Disaster Medicine, Warsaw, Poland.,Chair of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok, Poland
| | - Lukasz Szarpak
- Polish Society of Disaster Medicine, Warsaw, Poland. .,Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland. .,Maria Sklodowska-Curie Bialystok Oncology Centre, Bialystok, Poland.
| | | | - Michael Frass
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
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22
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Abstract
COVID-19 pandemic is mainly related with the pulmonary problems initially but now as the pandemic is growing it is observed that almost all organ systems of the body are affected. Up to 20-30% patients who are admitted in Covid hospitals are showing cardiovascular involvement. Severity of cardiovascular disease in a COVID-19 patient depends whether a patient is having pre-existing cardiac disease or not. Patients with pre-existing cardiac disease have more severe infection and associated mortality. Severe COVID-19 infection shows close association with myocardial damage and various arrythmias. The cardiovascular involvement occurs by either engagement directly with the angiotensin converting enzyme 2 or indirectly by the effect of inflammatory mediators which are generated as a result of viral-host response to infection. The COVID-19 disease is said to produce a wide spectrum of affliction ranging between even asymptomatic patient to Cardiovascular syndrome. Even after recovering from COVID-19 patients can reappear in the hospital with cardiomyopathies and arrythmias.
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Affiliation(s)
- Amit Rastogi
- Department of Anaesthesiology, SGPGI, Lucknow, Uttar Pradesh, India
| | - Prabhat Tewari
- Department of Anaesthesiology, SGPGI, Lucknow, Uttar Pradesh, India
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23
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Shah JZ, Kumar SA, Patel AA. Myocarditis and Pericarditis in Patients with COVID-19. Heart Views 2020; 21:209-214. [PMID: 33688413 PMCID: PMC7898989 DOI: 10.4103/heartviews.heartviews_154_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 08/20/2020] [Indexed: 01/08/2023] Open
Abstract
COVID-19 has been associated with a variety of cardiac manifestations. Myocarditis and pericarditis have been reported as one of the many cardiac manifestations in association with COVID-19. We describe below three cases of myocarditis, pericarditis with associated pericardial effusion and myopericarditis, respectively, in the setting of COVID-19. Although these entities may occur in isolation, they often occur in association to varying degrees. It could either be the initial diagnosis at the time of presentation or it could occur later in the course of COVID-19 infection. Pericarditis may occasionally be associated with significant pericardial effusion and tamponade requiring therapeutic pericardiocentesis. The assessment of pericardial effusion has been found to be exudative and is usually negative for SARS-CoV-2. Treatment of pericarditis with nonsteroidal anti-inflammatory drugs, colchicine, and corticosteroids has proven to be safe in COVID-19. Myocarditis may present with severe left ventricular systolic dysfunction and cardiogenic shock requiring inotropes and mechanical circulatory support.
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Affiliation(s)
- Jassim Zaheen Shah
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Smitha Anil Kumar
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ashfaq Ahmad Patel
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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24
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Naqvi SGZ, Naseeb U, Fatima K, Riffat S, Memon AG. Acute Pericarditis and Pericardial Effusion in a Hypertensive COVID-19 Patient. Cureus 2020; 12:e10705. [PMID: 33133870 PMCID: PMC7594656 DOI: 10.7759/cureus.10705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a contagious disease that has a potential of causing cardiovascular illness. Cardiac outcomes of COVID-19 mainly include acute coronary syndrome, heart failure, and left ventricular dysfunction. However, pericardial involvement is very rare. Here, we present a case of pericarditis and pericardial effusion in a known hypertensive COVID-19 patient. Our case was a diagnostic dilemma as the literature review mentioned that cardiovascular manifestations are mostly reported in symptomatic and critically ill patients of COVID-19. However, this patient has no viral respiratory illness, and is otherwise healthy.
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Affiliation(s)
- Syeda Ghadeer Zehra Naqvi
- Internal Medicine, Sindh Medical College, Jinnah Sindh Medical University, Karachi, PAK.,Cardiovascular Medicine, Jinnah Post Graduate Medical Center, Karachi, PAK
| | - Uzma Naseeb
- Internal Medicine, Sindh Medical College, Jinnah Sindh Medical University, Karachi, PAK
| | - Kainat Fatima
- Cardiovascular Medicine, Jinnah Post Graduate Medical Center, Karachi, PAK.,Cardiology, Sindh Medical College, Jinnah Sindh Medical University, Karachi, PAK
| | - Sumaira Riffat
- Physiology, Sindh Medical College, Jinnah Sindh Medical University, Karachi, PAK
| | - Anjuman Gul Memon
- Internal Medicine, College of Medicine, Qassim University, Buraidah, SAU
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25
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Sauer F, Dagrenat C, Couppie P, Jochum G, Leddet P. Pericardial effusion in patients with COVID-19: case series. EUROPEAN HEART JOURNAL-CASE REPORTS 2020; 4:1-7. [PMID: 33415315 PMCID: PMC7499573 DOI: 10.1093/ehjcr/ytaa287] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/26/2020] [Accepted: 07/29/2020] [Indexed: 11/17/2022]
Abstract
Background SARS-coronavirus-2 [coronavirus disease 2019 (COVID-19)] infection is a public health issue affecting millions of people. It started in Wuhan in China in December 2019 spreading rapidly worldwide. Case summary Three patients aged 51–84 developed a pericarditis related to COVID-19, associated for two of them with a myocarditis. Case 1 was a COVID-19 cardiac tamponade without myocarditis, confirmed by a positive chest computed tomography (CT) scan. Case 2 showed a COVID-19 myopericarditis, confirmed by a positive chest CT scan and a SARS-coronavirus-2 positive swab. Case 3 was a cardiac tamponade due to COVID-19 pericarditis, with a positive polymerase chain reaction on pericardial fluid. They were all treated by colchicine and their condition improved rapidly. Discussion Presumably rare, we reported three cases of pericardial effusions (PEs) occurring in a single cardiology centre. There is a higher incidence of COVID-19-related cardiac diseases such as pericarditis that can manifest as a minimal PE to a cardiac tamponade, which should result in a higher awareness of cardiologists. A systematic measure of the high-sensitivity troponin kinetic in patients affected by COVID-19 could be interesting in order to screen for potential myocarditis. Any unexplained haemodynamic failure or increased cardiac biomarkers should make the medical team search for myopericarditis by a transthoracic echocardiography.
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Affiliation(s)
- François Sauer
- Division of Cardiovascular Medicine, Centre Hospitalier de Haguenau, 64 Avenue du Professeur Leriche, Haguenau, Alsace 67500, France
| | - Charlotte Dagrenat
- Division of Cardiovascular Medicine, Centre Hospitalier de Haguenau, 64 Avenue du Professeur Leriche, Haguenau, Alsace 67500, France
| | - Philippe Couppie
- Division of Cardiovascular Medicine, Centre Hospitalier de Haguenau, 64 Avenue du Professeur Leriche, Haguenau, Alsace 67500, France
| | - Gaelle Jochum
- Division of Cardiovascular Medicine, Centre Hospitalier de Haguenau, 64 Avenue du Professeur Leriche, Haguenau, Alsace 67500, France
| | - Pierre Leddet
- Division of Cardiovascular Medicine, Centre Hospitalier de Haguenau, 64 Avenue du Professeur Leriche, Haguenau, Alsace 67500, France
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26
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Fox K, Prokup JA, Butson K, Jordan K. Acute Effusive Pericarditis: A Late Complication of COVID-19. Cureus 2020; 12:e9074. [PMID: 32656050 PMCID: PMC7348211 DOI: 10.7759/cureus.9074] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 07/08/2020] [Indexed: 12/22/2022] Open
Abstract
As the COVID-19 pandemic evolves, the medical community continues to discover novel clinical manifestations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Often, extrapulmonary manifestations occur simultaneously with pulmonary disease. However, there is a paucity of literature describing the cardiac manifestations of COVID-19 in the absence of pulmonary findings. We report a rare case of acute pericarditis presenting with pericardial effusion and cardiac tamponade in a 43-year-old man diagnosed with COVID-19. This case emphasizes the importance of continued investigation regarding diagnosis and treatment of COVID-19 and its related symptoms.
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Affiliation(s)
- Kelli Fox
- Internal Medicine, OhioHealth Riverside Methodist Hospital, Columbus, USA
| | - Jessica A Prokup
- Internal Medicine, OhioHealth Riverside Methodist Hospital, Columbus, USA
| | - Kyle Butson
- Internal Medicine, OhioHealth Riverside Methodist Hospital, Columbus, USA
| | - Kim Jordan
- Internal Medicine, OhioHealth Riverside Methodist Hospital, Columbus, USA
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