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Case report
Cardiac tamponade and massive pleural effusion in a young COVID-19-positive adult
  1. Dilip Johny1,
  2. Kodangala Subramanyam1,
  3. Nandakishore Baikunje2 and
  4. Giridhar Belur Hosmane2
  1. 1Cardiology, KS Hegde Medical Academy, Mangalore, Karnataka, India
  2. 2Pulmonary Medicine, KS Hegde Medical Academy, Mangalore, Karnataka, India
  1. Correspondence to Dr Dilip Johny; johnydilip{at}gmail.com

Abstract

COVID-19 has a broad spectrum of cardiac manifestations, and cardiac tamponade leading to cardiogenic shock is a rare presentation. A 30-year-old man with a history of COVID-19-positive, reverse transcription polymerase chain reaction (RT-PCR) done 1 week ago and who was home-quarantined, came to the emergency department with palpitations, breathlessness and orthopnoea. His ECG showed sinus tachycardia with low-voltage complexes, chest X-ray showed cardiomegaly and left pleural effusion and two-dimensional echocardiography showed large pericardial effusion with features suggestive of cardiac tamponade. He was taken up for emergency pericardiocentesis which showed haemorrhagic pericardial fluid. Intercostal drainage insertion was done for left-sided large pleural effusion. After ruling out all the other causes for haemorrhagic pericardial effusion, the patient was started on colchicine, steroids, ibuprofen and antibiotics to which he responded. Both pericardial and pleural effusions resolved completely on follow-up.

  • cardiovascular medicine
  • pericardial disease
  • COVID-19
  • respiratory system

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-244518

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    Footnotes

    • Twitter @nandanbaikunje

    • Contributors DJ: concepts, design, literature search, data acquisition, manuscript editing, management of the patient and supervision of the case. SK: overall management of the patient and life-saving pericardiocentesis, concepts, design, manuscript editing and supervision of the case. NB and GBH: clinical management and intercostal chest tube drainage insertion.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.