Key result
Emergent pericardiocentesis and medical management successfully resolved a rare case of COVID-19 myopericarditis complicated by cardiac tamponade and rhabdomyolysis in a 42-year-old female.
Why the study?
COVID-19 is a multi-organ disease affecting the cardiovascular system that can present with myocarditis, but uncommon presentations require better clinical understanding.
Case Report (n=1)
COVID-19 can present with uncommon cardiovascular manifestations such as myopericarditis with cardiac tamponade and rhabdomyolysis, which can be successfully managed with pericardiocentesis and standard medical therapy.
Answers are grounded in this paper and cite their sources.
Alerts clinicians to tamponade in COVID-19 myopericarditis; case report leaves open need for systematic study.
COVID-19 infection is a complex multi-organ disease, including the cardiovascular system, which may present with myocarditis. A 42-year-old female presented to our ED with generalized weakness, myalgia, and epigastric pain. Laboratory workup showed a positive SARS-CoV-2 polymerase chain reaction (PCR). An ECG showed sinus tachycardia with low voltage. A bedside echocardiogram showed a pericardial effusion with cardiac tamponade. An emergent pericardiocentesis was performed with immediate hemodynamic improvement. The patient was admitted to the coronary care unit (CCU), and colchicine and ibuprofen were started for pericarditis. Pericardial fluid bacterial and fungal cultures were negative, and serum antinuclear antibodies were also negative. On day 5 of hospitalization, creatine kinase (CK) level was high compared to on presentation. COVID-induced rhabdomyolysis was suspected and was dramatically improved with IV fluids. The patient was discharged on day 7 of admission. Our case shows that COVID-19 can present with an uncommon presentation like cardiac tamponade. Further studies are warranted to better understand the pathogenesis and management of COVID-19 myopericarditis.
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Abdelmottaleb et al. (2022) conducted a case report in COVID-19 Myopericarditis with Pericardial Effusion, Cardiac Tamponade, and Rhabdomyolysis (n=1). Pericardiocentesis and medical management (colchicine, ibuprofen, IV fluids) was evaluated on Clinical improvement and resolution of symptoms. Emergent pericardiocentesis and medical management successfully resolved a rare case of COVID-19 myopericarditis complicated by cardiac tamponade and rhabdomyolysis in a 42-year-old female.
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