Key result
Combined pericardiectomy and corticosteroids resolve HF symptoms in a case of post-COVID-19 effusive-constrictive pericarditis.
Why the study?
SARS-CoV-2 infection can cause cardiovascular complications including rare cases of effusive-constrictive pericarditis, but literature on COVID-19-related pericarditis remains limited.
Case Report (n=1)
No
This case highlights the diagnostic and therapeutic challenges of effusive-constrictive pericarditis post-COVID-19, demonstrating the utility of CMR and the potential benefit of immunosuppressive therapy for residual symptoms after pericardiectomy.
May inform management of refractory post-COVID effusive-constrictive pericarditis; hypothesis-generating and should not yet change practice.
Dnes je ji prokzno, e infekn onemocnn SARS-CoV-2, zprvu povaovan za respiran onemocnn, zpsobuje kardiovaskulrn komplikace vetn vzcnch ppad efuzivn-konstriktivn perikarditidy. Popisujeme ppad 45letho mue, u nho dolo po pekonn infeknho onemocnn covid-19 s mrnm prbhem k rozvoji efuzivn-konstriktivn perikarditidy. Pacient byl pvodn pijat pro akutn perikarditidu s malm perikardilnm vpotkem lenm ibuprofenem a colchicinem. O dva tdny pozdji se mu dostavil k vyeten znovu pro zhorujc se symptomy srdenho selhn vetn ortopnoe, otok a navy. Vyeten srdce echokardiograficky a magnetickou rezonanc (cardiac magnetic resonance, CMR) ukzala na ptomnost efuzivn-konstriktivn perikarditidy a subakutn myokarditidy. Pes protizntlivou lbu a podvn diuretik symptomy petrvvaly, a vydaly si tak perikardiektomii. Perikard byl siln ztlutl s rozshlmi srsty. Symptomy srdenho selhn petrvvajc po operaci a nlez fibrznho perikardu zobrazovacmi metodami vedly k zahjen lby kortikosteroidy s nslednm vymizenm symptom. Tento ppad nzorn ukazuje nronost diagnostiky a lby efuzivn-konstriktivn perikarditidy v kontextu infeknho onemocnn covid-19. Identifikaci aktivnho zntu perikardu a veden lby napomohlo pouit neinvazivnch zobrazovacch metod, zvlt CMR. Zatmco perikardiektomie pedstavuje i nadle rezolutn intervenci v jinak neeitelnch ppadech, popsan ppad ukazuje na potenciln pnos imunosupresivn lby pro vymizen rezidulnch symptom. Vzhledem k omezenmu mnostv literatury na tma perikarditidy v souvislosti s infeknm onemocnnm covid-19 je pro optimalizaci vsledku lby a smovn dalho vzkumu nutn multidisciplinrn pstup.
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Pacheco et al. (2025) conducted a case report in Effusive-constrictive pericarditis following mild COVID-19 (n=1). Pericardiectomy and corticosteroid therapy was evaluated on Symptom resolution. Combined pericardiectomy and corticosteroid therapy successfully resolved persistent heart failure symptoms in a patient with effusive-constrictive pericarditis following mild COVID-19.
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