BMJ Case Rep . Coronavirus disease 2019 (COVID-19)-associated constrictive pericarditis

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BMJ Case Rep


. 2021 May 11;14(5):e242018.
doi: 10.1136/bcr-2021-242018.
Coronavirus disease 2019 (COVID-19)-associated constrictive pericarditis


Jennifer Kate Beckerman ¹ , Mohammad Alarfaj ² , Cynthia M Tracy ³ , Ariel D Faiwiszewski ³ , Andrew D Choi ⁴



Affiliations

• PMID: 33975843
• DOI: 10.1136/bcr-2021-242018

Abstract

This report documents a rare case of COVID-19-associated constrictive pericarditis (CP) in the setting of a recent COVID-19 infection. A 55-year-old man with a history of hypertension and gout presented with acute hypoxic respiratory failure and was diagnosed with COVID-19 pneumonia with progression to acute respiratory distress syndrome. His hospital course was complicated by a large pericardial effusion; an emergent bedside transthoracic echocardiography was concerning for cardiac tamponade, so pericardiocentesis was performed. A workup with cardiac magnetic resonance imaging showed changes consistent with a diagnosis of CP. Viral and idiopathic aetiologies are the most common cause of CP in the developed world, with COVID-19 now a proposed predisposing viral illness. The virus induces systemic inflammation and pericardial changes that can lead to CP physiology. Imaging modalities including echocardiogram and cardiac magnetic resonance play an integral role in confirming the diagnosis.

Keywords: COVID-19; cardiovascular medicine; cardiovascular system; infectious diseases; pericardial disease.