Patel Viral D, Patel Khushbu H, Lakhani Dhairya A, Desai Rupak, Mehta Deep, Mody Priyank, Pruthi Sumit
Department of Internal Medicine, Sanjivani Hospital & Texas Heart Institute, Surat, Gujarat, India.
Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
AME Case Rep. 2021 Jan 25;5:6. doi: 10.21037/acr-20-90. eCollection 2021.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as coronavirus disease 2019 (COVID-19) is known to cause a cluster of flu-like illnesses and pneumonia with evolving understanding of other systemic manifestations. Currently, the known cardiac manifestations of COVID-19 include myocardial injury, acute coronary syndrome, and arrhythmias. In this report, we describe a case of pericarditis-an unusual cardiac manifestation observed in a patient with COVID-19. A 63-year-old male presented with history of fever, cough and chest pain. Electrocardiogram (EKG) demonstrated diffuse ST-T wave changes on all the leads, with normal troponin-T levels. Echocardiograph showed mild pericardial effusion without any regional wall motion abnormality. Subsequent chest radiograph and coronary angiography were normal. In view of ongoing COVID-19 pandemic, nasopharyngeal swab was performed, which was positive. Detailed etiological workup for pericarditis, including infectious and inflammatory causes were unremarkable. Viral pericarditis (possibly caused by COVID-19) was diagnosis of exclusion and patient was treated with hydroxychloroquine 200 mg twice a day, colchicine 0.5 mg twice a day, and lopinavir/ritonavir 200 mg/50 mg tablet twice a day for 10 days during admission. He was discharged with hydroxychloroquine 200 mg twice daily and colchicine 0.5 mg once daily for 15 days. On subsequent follow-up clinic visit, he reported resolution of symptoms. The purpose of this report is to add a potential cardiovascular complication of COVID-19 to the literature. Awareness of this manifestation can lead to timely laboratory and imaging examinations with potential to provide correct treatment and good outcome.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2），也被称为2019冠状病毒病（COVID-19），已知会引发一系列类似流感的疾病和肺炎，同时人们对其其他全身表现的认识也在不断深入。目前，COVID-19已知的心脏表现包括心肌损伤、急性冠状动脉综合征和心律失常。在本报告中，我们描述了一例心包炎病例——这是在一名COVID-19患者中观察到的不寻常心脏表现。一名63岁男性患者，有发热、咳嗽和胸痛病史。心电图（EKG）显示所有导联均有弥漫性ST-T波改变，肌钙蛋白T水平正常。超声心动图显示有轻度心包积液，无任何节段性室壁运动异常。随后的胸部X线片和冠状动脉造影均正常。鉴于COVID-19大流行仍在持续，进行了鼻咽拭子检测，结果呈阳性。针对心包炎的详细病因检查，包括感染性和炎症性病因，均无异常发现。病毒性心包炎（可能由COVID-19引起）是排除性诊断，患者在住院期间接受了每天两次200毫克羟氯喹、每天两次0.5毫克秋水仙碱以及每天两次200毫克/50毫克洛匹那韦/利托那韦片治疗，持续10天。出院时，患者服用每天两次200毫克羟氯喹和每天一次0.5毫克秋水仙碱，持续15天。在随后的门诊随访中，他报告症状已缓解。本报告的目的是在文献中增加COVID-19一种潜在的心血管并发症。认识到这种表现可促使及时进行实验室和影像学检查，有可能提供正确的治疗并取得良好的结果。
