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.
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。