Acute perimyocarditis with cardiac tamponade in COVID-19 infection without respiratory disease

Area of Science:

• Cardiology
• Infectious Diseases
• Critical Care Medicine

Background:

• The COVID-19 pandemic has strained healthcare systems, with severe respiratory illness leading to hospital and ICU overflows.
• Cardiac injury, indicated by elevated troponins and natriuretic peptides, is associated with poor prognosis in COVID-19 patients.

Observation:

• A young woman with COVID-19 presented with hemodynamic instability.
• The instability was attributed to acute perimyocarditis and cardiac tamponade, with modestly elevated Troponin T.
• Focused cardiac ultrasound and echocardiography revealed transient myocardial wall thickening.

Findings:

• Diagnosis of acute perimyocarditis and cardiac tamponade was confirmed via focused cardiac ultrasound.
• Echocardiography demonstrated transient thickening of the myocardial walls.
• The patient significantly improved within one week following pericardial drainage and supportive care, without specific targeted therapy.

Implications:

• This case highlights the critical role of cardiac diagnostic imaging in managing COVID-19 patients.
• Prompt diagnosis and intervention, such as pericardial drainage, can lead to significant recovery.
• Elevated cardiac biomarkers in COVID-19 necessitate thorough cardiac evaluation.