Internal medicine

Transthoracic echocardiogram

Pericardiocentesis

Cardiac tamponade

Chest pain

Pericardial fluid

Pericarditis

Myopericarditis

Cardiology

Intensive care unit

Tamponade

Tachycardia

Myocarditis

Pericardial effusion

Anesthesia

Medicine

European Heart Journal

This case report describes the clinical course and management of a 47-year-old Afro-Caribbean with previous myopericarditis was admitted in March 2020 with breathlessness, chest pain, dry cough, and subjective fevers null She had no cardiovascular risk factors null An angiogram in 2017 had shown unobstructed coronary arteries null Despite initial i v null fluid resuscitation, she did not respond and was transferred to the intensive treatment unit (ITU) for vasopressor support null Repeat echocardiogram revealed further accumulation of pericardial effusion to a maximal depth of 2 cm, with evidence of cardiac tamponade null Her haemodynamic parameters worsened, including hypotension and tachycardia null Pericardiocentesis was performed in view of acute deterioration null Due to her clinical condition and infective status, it was deemed unsuitable to transfer her to the cardiac laboratory for fluoroscopic-guided pericardiocentesis null This was therefore performed on the ITU under echocardiographic guidance null Improvement in haemodynamic parameters was observed immediately null A total of 540 mL of serosanguinous fluid was drained and tested negative for COVID-19 null This case report highlights the first cardiac tamponade case in COVID-19 null Cardiac tamponade is an important differential to consider in a deteriorating patient with COVID-19

Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19