PDF(Pubmed)
Abstract：
BACKGROUND: The COVID-19 pandemic was primarily considered a respiratory malady in the early phases of the outbreak. However, as more patients suffer from this illness, a myriad of symptoms emerge in organ systems separate from the lungs. Among those patients with cardiac involvement, myocarditis, pericarditis, myocardial infarction, and arrhythmia were among the most common manifestations. Pericarditis with pericardial effusion requiring medical or interventional treatments has been previously reported in the acute setting. Notably, chronic pericarditis with pericardial thickening resulting in constriction requiring sternotomy and pericardiectomy has not been published to date.
METHODS: A patient with COVID-19-associated constrictive pericarditis three years after viral infection requiring pericardiectomy was reported. The COVID-19 infection originally manifested as anosmia and ageusia. Subsequently, the patient developed dyspnea, fatigue, right-sided chest pressure, bilateral leg edema, and abdominal fullness. Following recurrent right pleural effusions and a negative autoimmune work-up, the patient was referred for cardiothoracic surgery for pericardiectomy when radiographic imaging and hemodynamic assessment were consistent with constrictive pericarditis. Upon median sternotomy, the patient\'s pericardium was measured to be 8 mm thick. Descriptions of the clinical, diagnostic, and therapeutic features are provided. Within the first week after the operation, the patient\'s dyspnea resolved; one month later, leg edema and abdominal bloating were relieved.
CONCLUSIONS: Although an association between COVID-19 and cardiac complications has been established, this case adds another element of virus severity and chronic manifestations. The need for sternotomy and pericardiectomy to treat COVID-19-related constrictive pericarditis is believed to be the first reported diagnosis.
METHODS: A patient with COVID-19-associated constrictive pericarditis three years after viral infection requiring pericardiectomy was reported. The COVID-19 infection originally manifested as anosmia and ageusia. Subsequently, the patient developed dyspnea, fatigue, right-sided chest pressure, bilateral leg edema, and abdominal fullness. Following recurrent right pleural effusions and a negative autoimmune work-up, the patient was referred for cardiothoracic surgery for pericardiectomy when radiographic imaging and hemodynamic assessment were consistent with constrictive pericarditis. Upon median sternotomy, the patient\'s pericardium was measured to be 8 mm thick. Descriptions of the clinical, diagnostic, and therapeutic features are provided. Within the first week after the operation, the patient\'s dyspnea resolved; one month later, leg edema and abdominal bloating were relieved.
CONCLUSIONS: Although an association between COVID-19 and cardiac complications has been established, this case adds another element of virus severity and chronic manifestations. The need for sternotomy and pericardiectomy to treat COVID-19-related constrictive pericarditis is believed to be the first reported diagnosis.
摘要：
背景：COVID-19大流行在爆发的早期阶段主要被认为是一种呼吸道疾病。然而,随着越来越多的患者患有这种疾病，无数的症状出现在与肺部分离的器官系统中。在那些心脏受累的患者中，心肌炎,心包炎,心肌梗塞,心律失常是最常见的表现。先前已在急性环境中报道了心包炎伴心包积液需要医学或介入治疗。值得注意的是,慢性心包炎伴心包增厚导致需要胸骨切开术和心包切除术的收缩至今尚未发表。
方法：报道了一例COVID-19相关性缩窄性心包炎病毒感染3年后需要进行心包切除术的患者。COVID-19感染最初表现为嗅觉缺失和迟钝。随后，患者出现呼吸困难,疲劳,右侧胸压,双侧腿部水肿,腹部丰满。在复发性右侧胸腔积液和阴性自身免疫检查后，当X线影像学和血流动力学评估与缩窄性心包炎一致时,患者被转介心胸手术行心包切除术.正中胸骨切开术后，患者的心包厚度为8毫米。临床描述，诊断,并且提供治疗特征。手术后的第一周内，患者的呼吸困难消退；一个月后，腿部水肿和腹胀缓解。
结论：尽管已经确定了COVID-19与心脏并发症之间的关联，这种情况增加了病毒严重程度和慢性表现的另一个因素。胸骨切开术和心包切除术治疗COVID-19相关缩窄性心包炎被认为是第一个报道的诊断。
方法：报道了一例COVID-19相关性缩窄性心包炎病毒感染3年后需要进行心包切除术的患者。COVID-19感染最初表现为嗅觉缺失和迟钝。随后，患者出现呼吸困难,疲劳,右侧胸压,双侧腿部水肿,腹部丰满。在复发性右侧胸腔积液和阴性自身免疫检查后，当X线影像学和血流动力学评估与缩窄性心包炎一致时,患者被转介心胸手术行心包切除术.正中胸骨切开术后，患者的心包厚度为8毫米。临床描述，诊断,并且提供治疗特征。手术后的第一周内，患者的呼吸困难消退；一个月后，腿部水肿和腹胀缓解。
结论：尽管已经确定了COVID-19与心脏并发症之间的关联，这种情况增加了病毒严重程度和慢性表现的另一个因素。胸骨切开术和心包切除术治疗COVID-19相关缩窄性心包炎被认为是第一个报道的诊断。
