Acute life-threatening cardiac tamponade in a mechanically ventilated patient with COVID-19 pneumonia
Vaia Derveni,
Evangelos Kaniaris,
Dimitris Toumpanakis,
Efstathia Potamianou,
Ilianna Ioannidou,
Danai Theodoulou,
Anna Kyriakoudi,
Magda Kyriakopoulou,
Konstantinos Pontikis,
Maria Daganou
Affiliations
Vaia Derveni
ICU First Department of Respiratory Medicine, Medical School, University of Athens, Sotiria Hospital, Athens, Greece
Evangelos Kaniaris
ICU First Department of Respiratory Medicine, Medical School, University of Athens, Sotiria Hospital, Athens, Greece
Dimitris Toumpanakis
ICU First Department of Respiratory Medicine, Medical School, University of Athens, Sotiria Hospital, Athens, Greece
Efstathia Potamianou
ICU First Department of Respiratory Medicine, Medical School, University of Athens, Sotiria Hospital, Athens, Greece
Ilianna Ioannidou
ICU First Department of Respiratory Medicine, Medical School, University of Athens, Sotiria Hospital, Athens, Greece
Danai Theodoulou
ICU First Department of Respiratory Medicine, Medical School, University of Athens, Sotiria Hospital, Athens, Greece
Anna Kyriakoudi
ICU First Department of Respiratory Medicine, Medical School, University of Athens, Sotiria Hospital, Athens, Greece
Magda Kyriakopoulou
ICU First Department of Respiratory Medicine, Medical School, University of Athens, Sotiria Hospital, Athens, Greece
Konstantinos Pontikis
ICU First Department of Respiratory Medicine, Medical School, University of Athens, Sotiria Hospital, Athens, Greece
Maria Daganou
Corresponding author at: ICU First Department of Respiratory Medicine, Medical School, University of Athens, Sotiria Hospital, 152 Mesogion Avenue, 11527 Athens, Greece.; ICU First Department of Respiratory Medicine, Medical School, University of Athens, Sotiria Hospital, Athens, Greece
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has recently evolved as a pandemic disease. Although the respiratory system is predominantly affected, cardiovascular complications have been frequently identified, including acute myocarditis, myocardial infarction, acute heart failure, arrhythmias and venous thromboembolic events. Pericardial disease has been rarely reported. We present a case of acute life-threatening cardiac tamponade caused by a small pericardial effusion in a mechanically ventilated patient with severe COVID-19 associated pneumonia. The patient presented acute circulatory collapse with hemodynamic features of cardiogenic or obstructive shock. Bedside echocardiography permitted prompt diagnosis and life-saving pericardiocentesis. Further investigation revealed no other apparent cause of pericardial effusion except for SARS-CoV-2 infection. Cardiac tamponade may complicate COVID-19 and should be included in the differential diagnosis of acute hemodynamic deterioration in mechanically ventilated COVID-19 patients.
