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[一名急性严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)感染患者的心脏压塞和心肌炎]

[Cardiac tamponade and myocarditis in a patient with acute SARS-CoV-2 infection].

作者信息

Flores Cevallos Samantha S, Ruiz Martínez Juan José, Duran Ana L, Roberti Javier, Sosa Fernando A

机构信息

Hospital Alemán, Buenos Aires, Argentina.

Hospital Alemán, Buenos Aires, Argentina. E-mail:

出版信息

Medicina (B Aires). 2021;81(6):1045-1047.

Abstract

We describe a patient with COVID-19, with pericardial effusion, cardiac tamponade and severe myocardial depression. A 51-year-old woman, previously healthy, with mild COVID-19 presented with three episodes of syncope. She was admitted to the emergency room. An electrocardiogram showed sinus rhythm, diffuse superior concavity ST 2 mv; a CT scan showed pericardial effusion, without lung pathological findings. Due to shock, dyspnoea and encephalopathy, the patient was admitted to intensive care, where she received vasopressor support and mechanical ventilation. A bedside ultrasound showed pericardial effusion and tamponade; drainage was performed; transoesophageal ultrasound showed moderate deterioration of biventricular systolic function; global longitudinal strain -14.2%, estimated Fey 43%; global circumferential strain -10.1%. Seven days after admission, CT scan revealed bilateral infiltrates and pericardial thickening with post-contrast enhancement and mild pericardial effusion. On day 12 post admission, inotropic support was discontinued; patient on mechanical ventilation weaning and haemodynamically stable.

摘要

我们描述了一名患有新型冠状病毒肺炎(COVID-19)的患者,伴有心包积液、心脏压塞和严重心肌抑制。一名51岁的女性,既往健康,患有轻度COVID-19,出现了三次晕厥发作。她被送往急诊室。心电图显示窦性心律,弥漫性上凹ST段抬高2mV;CT扫描显示心包积液,肺部无病理表现。由于休克、呼吸困难和脑病,患者被收入重症监护病房,在那里接受了血管活性药物支持和机械通气。床旁超声显示心包积液和心脏压塞;进行了引流;经食管超声显示双心室收缩功能中度恶化;整体纵向应变-14.2%,估计射血分数43%;整体圆周应变-10.1%。入院7天后,CT扫描显示双侧浸润以及心包增厚伴造影剂后强化和轻度心包积液。入院后第12天,停用了正性肌力药物支持;患者正在撤机且血流动力学稳定。

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