Ectopia cordis in an adult patient with COVID-19: A case report and literature review

Abstract

Ectopia cordis (EC) is a rare congenital condition characterized by a partial or complete defect of the anterior chest wall. It is associated with ventricular and atrial septal defects (ASD), Ebstein's anomaly, truncus arteriosus, transposition of the great vessels, tetralogy of Fallot, and hypoplastic left heart syndrome. This study aimed to explore the cardiac manifestations of EC complicated by coronavirus disease 2019 (COVID-19). A 23-year-old male, born with EC, was admitted to the hospital for acute cough and fever. The patient was diagnosed with EC and ASD by computed tomography and COVID-19 via a polymerase chain reaction swab test. Patients with ECs rarely survive till adulthood. However, due to the rarity of this syndrome, upon literature review, we did not find a case of EC with concurrent COVID-19 infection. The patient underwent the required investigations and conventional treatment such as fluid resuscitation, antibiotics administration, and full code cardiopulmonary resuscitation. The interventions performed were unsuccessful, and the patient died. This case demonstrates a patient who lived with EC and its associated cardiac anomalies but died of COVID-19 and its complications despite full resuscitation attempts. Our findings suggest that patients with EC may survive to adulthood if they have an incomplete EC, fewer intracardiac defects except for ASD, and an absence of an omphalocele.

Keywords: COVID‐19 infection; adult ectopia cordis; congenital cardiac disease; critical cardiovascular disease.

FIGURE 1

A frontal chest radiograph reveals bilateral patchy opacities throughout both lungs suggestive of ongoing infectious process

FIGURE 2

An enhanced computed tomography scan of the chest was performed to evaluate shortness of breath and chest pain. This shows partial ectopia cordis with right ventricular outflow tract herniation. The heart is seen extending through a midline defect in the sternum and lying outside the thorax, covered only by the skin. Atrial septal defect is also noted

FIGURE 3

Lung window image of enhanced chest computed tomography scan reveals scattered ground‐glass opacities and patchy lung consolidation with the peripheral distribution. Viral infection was considered