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Case Reports
. 2020 Nov;35(11):3183-3190.
doi: 10.1111/jocs.14925. Epub 2020 Aug 13.

Cardiac tamponade in COVID-19 patients: Management and outcomes

Hazim Hakmi  1 , Amir Sohail  1 , Collin Brathwaite  1 , Beevash Ray  2 , Sunil Abrol  3
Affiliations
Case Reports

Cardiac tamponade in COVID-19 patients: Management and outcomes

Hazim Hakmi et al. J Card Surg. 2020 Nov.

Abstract

Importance: Cardiac tamponade requiring emergent intervention is a possible complication of coronavirus disease 2019 (COVID-19) infection. Favorable clinical outcomes are possible if timely management and drainage are performed unless ventricular failure develops.

Observation: Cardiac tamponade in COVID-19, based on the limited reported cases, seems to be more common among middle-aged men with observed complications in black and ethnic minorities. Prognosis is worse amongst patients with concomitant ventricular failure.

Design and methods: This is a case series of three COVID-19 patients complicated by cardiac tamponade, requiring surgical intervention at a single institution in New York.

Intervention: Pericardial window, Pericardiocentesis.

Outcome: One patient had recurrence of cardiac tamponade with hemorrhagic component but fully recovered and was discharged home. Two patients developed cardiac tamponade with concomitant biventricular failure, resulting in death.

Conclusion and relevance: Cardiac tamponade with possible concomitant biventricular failure can develop in COVID-19 patients; incidence seems to be highest at the point of marked inflammatory response. Concomitant ventricular failure seems to be a predictor of poor prognosis.

Keywords: COVID-19; pericardial effusion; tamponade; ventricular failure.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
A, Top left, subcostal view: There is a large circumferential pericardial effusion. B, Top right, continuous wave Doppler through the mitral valve in the four chamber apical view: This image shows significant (>30%) respiratory variation in mitral inflow velocity. C, Bottom, subcostal view: There is a large circumferential pericardial effusion with visible partial collapse of the right ventricle and right atrium
Figure 2
Figure 2
Subcostal view: There is a large circumferential pericardial effusion
Figure 3
Figure 3
A, Top left, continuous wave Doppler through the mitral valve in the two chamber apical view: This image shows significant (>30%) respiratory variation in mitral inflow velocity. B, Top right, apical four chamber view: There is a moderate size effusion adjacent to the right atrium with partial right atrial collapse. C, Bottom, subcostal view: The inferior vena cava is plethoric measuring 2.9 cm
See this image and copyright information in PMC

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