In most cases of cardiac tamponade, there is no known cause and the condition is idiopathic. However, in some patients, infections are the cause for this condition. The author wrote, “Not much data is available regarding the cardiovascular complications in COVID-19 patients. The cardiovascular complications reported are myocarditis, arrhythmia, congestive heart failure, hypercoagulability, and cardiac tamponade physiology.” COVID-19 patients suffering from cardiac tamponade may develop exudative, sanguineous, or transudative pericardial fluid.

The possible complication of COVID-19 is the cardiac tamponade requiring emergent intervention. The study concludes that if the proper drainage and timely management are available before the ventricular failure develops, there are possibilities of favorable clinical outcomes.

The study makes use of three case studies that include patients suffering from cardiac tamponade. The first patient was a 48-year-old male with a history of diabetes. He was positive for COVID-19 and the echocardiogram shows moderate?to?large pericardial effusion along with tamponade physiology. The percutaneous drainage was done in the patient and the patient underwent anticoagulation therapy. After another pericardial drainage, there were no postoperative events. The doctors discharged the patients within 10 days after the second procedure.

The second patient was a 56-year-old male with no medical history and was suffering from fever, cough, and chest pain for one week. The COVID-19 test was positive and the echocardiogram shows pericardial effusion and tamponade physiology. He underwent drainage, however, expired later. The probable cause of his death may be a post?drainage pericardial decompression syndrome or cardiogenic shock due to severe ventricular dysfunction.

The third patient was a 55-year-old male who had a medical history of obesity and hypertension. He had a fever, chills, dyspnea, and fatigue for the last two weeks. He was tested positive for COVID-19. An echocardiogram shows pericardial effusion and cardiac tamponade physiology. The patient was pronounced dead due to biventricular failure.

Cardiac tamponade may lead to biventricular failure that may result in death in COVID-19 patients. It is important to provide immediate medical interventions to such patients.


Hakmi H, Sohail A, Brathwaite C, Ray B, Abrol S. Cardiac tamponade in COVID-19 patients: Management and outcomes. J Card Surg. 2020 Nov;35(11):3183-3190. doi: 10.1111/jocs.14925. Epub 2020 Aug 13. PMID: 32790006; PMCID: PMC7436377.