Basingstoke and North Hampshire Hospital, Hampshire Hospitals Foundation Trust, Hampshire, United Kingdom.
J Med Case Rep. 2021 Jan 25;15(1):31. doi: 10.1186/s13256-020-02618-z.
Previous reports have shown various cardiac complications to be associated with COVID-19 including: myocardial infarction, microembolic complications, myocardial injury, arrythmia, heart failure, coronary vasospasm, non-ischemic cardiomyopathy, stress (Takotsubo) cardiomyopathy, pericarditis and myocarditis. These COVID-19 cardiac complications were associated with respiratory symptoms. However, our case illustrates that COVID-19 myopericarditis with cardiac tamponade can present without respiratory symptoms.
A 58-year-old Caucasian British woman was admitted with fever, diarrhoea and vomiting. She developed cardiogenic shock and Transthoracic echocardiogram (TTE) found a pericardial effusion with evidence of cardiac tamponade. A nasopharyngeal swab showed a COVID-19 positive result, despite no respiratory symptoms on presentation. A pericardial drain was inserted and vasopressor support required on intensive treatment unit (ITU). The drain was removed as she improved, an antibiotic course was given and she was discharged on day 12.
Our case demonstrates that patients without respiratory symptoms could have COVID-19 and develop cardiac complications. These findings can aid timely diagnosis of potentially life-threatening COVID-19 myopericarditis with cardiac tamponade.
先前的报告表明，COVID-19 可引起多种心脏并发症，包括：心肌梗死、微栓塞并发症、心肌损伤、心律失常、心力衰竭、冠状动脉痉挛、非缺血性心肌病、应激性（Takotsubo）心肌病、心包炎和心肌炎。这些 COVID-19 心脏并发症与呼吸系统症状相关。然而，我们的病例表明，COVID-19 心肌炎伴心包填塞可在无呼吸系统症状的情况下发生。
一名 58 岁的白人英国女性因发热、腹泻和呕吐而入院。她出现心源性休克，经经胸超声心动图（TTE）发现心包积液并伴有心包填塞证据。鼻拭子检测结果显示 COVID-19 阳性，尽管就诊时无呼吸系统症状。置入心包引流管并在重症监护病房（ICU）给予升压支持。随着病情的改善，引流管被移除，给予抗生素治疗，患者于第 12 天出院。
我们的病例表明，无呼吸系统症状的患者可能患有 COVID-19 并发生心脏并发症。这些发现有助于及时诊断可能危及生命的 COVID-19 心肌炎伴心包填塞。
