[Cardiac tamponade and myocarditis in a patient with acute SARS-CoV-2 infection]

Area of Science:

• Cardiology
• Infectious Diseases
• Critical Care Medicine

Background:

• Coronaviruses, including SARS-CoV-2, can cause a range of cardiovascular complications.
• Myocardial depression and pericardial disease are recognized, though less common, manifestations of COVID-19.

Observation:

• A previously healthy 51-year-old woman with mild COVID-19 presented with syncope, shock, dyspnea, and encephalopathy.
• Initial CT revealed pericardial effusion; bedside ultrasound confirmed cardiac tamponade, necessitating drainage.
• Transesophageal echocardiography demonstrated moderate biventricular systolic dysfunction with reduced global longitudinal and circumferential strain.

Findings:

• The patient required intensive care with vasopressor support and mechanical ventilation.
• Follow-up CT showed evolving bilateral infiltrates, pericardial thickening, and residual effusion.
• Cardiac function gradually improved, allowing discontinuation of inotropic support and weaning from mechanical ventilation.

Implications:

• This case highlights the potential for severe cardiac manifestations, including tamponade and myocardial depression, in patients with COVID-19, even with initially mild disease.
• Prompt recognition and management of these cardiac complications are essential for improving patient outcomes.
• Further research is warranted to understand the mechanisms and long-term cardiovascular sequelae of SARS-CoV-2 infection.