Acute perimyocarditis with cardiac tamponade in COVID-19 infection without respiratory disease

BMJ Case Rep. 2020 Aug 19;13(8):e236218. doi: 10.1136/bcr-2020-236218.


The COVID-19 pandemic with its severe respiratory disease has caused overflow to hospitals and intensive care units. Elevated troponins and natriuretic peptides are related to cardiac injury and poor prognosis. We present a young woman with COVID-19 infection with haemodynamic instability caused by acute perimyocarditis and cardiac tamponade. Troponin T was modestly elevated. Focused cardiac ultrasound made the diagnosis. Echocardiography revealed transient thickening of the myocardial walls. After pericardial drainage and supportive care, she improved significantly within 1 week without targeted therapy. The case illustrates the importance of cardiac diagnostic imaging in patients with COVID-19 and elevated cardiac biomarkers.

Keywords: infectious diseases; pericardial disease.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Betacoronavirus*
  • Biomarkers / blood
  • COVID-19
  • Cardiac Tamponade / blood
  • Cardiac Tamponade / virology*
  • Coronavirus Infections / blood
  • Coronavirus Infections / complications*
  • Coronavirus Infections / virology
  • Female
  • Humans
  • Middle Aged
  • Myocarditis / blood
  • Myocarditis / virology*
  • Pandemics
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / virology
  • SARS-CoV-2
  • Troponin T / blood


  • Biomarkers
  • Troponin T