Pulmonary Embolism and Cardiac Tamponade in Critical Care Patients with COVID-19; Telemedicine's Role in Developing Countries: Case Reports and Literature Review

Islam Mohammed Sheata; Scott Richard Smith; Heba Kamel; Giustino Varrassi; Farnad Imani; Abdolreza Dayani; Dariusz Myrcik; Ivan Urits; Omar Viswanath; Sameh Salem Taha

doi:10.5812/aapm.113752

Pulmonary Embolism and Cardiac Tamponade in Critical Care Patients with COVID-19; Telemedicine's Role in Developing Countries: Case Reports and Literature Review

Anesth Pain Med. 2021 Apr 7;11(2):e113752. doi: 10.5812/aapm.113752. eCollection 2021 Apr.

Authors

Islam Mohammed Sheata¹, Scott Richard Smith², Heba Kamel³, Giustino Varrassi⁴, Farnad Imani⁵, Abdolreza Dayani⁶, Dariusz Myrcik⁷, Ivan Urits^{8

9}, Omar Viswanath^{9

10

11

12}, Sameh Salem Taha¹

Affiliations

¹ Anesthesia Department, Ain Shams University, Cairo, Egypt.
² Department of Anesthesiology, University of Florida, Florida, USA.
³ Congenital and Structural Heart Disease Unit, Cardiology Department, Ain Shams University, Cairo, Egypt.
⁴ Paolo Procacci Foundation, Roma, Italy.
⁵ Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.
⁶ Cardiac Anesthesia Department, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
⁷ Department of Internal Medicine, University of Silesia in Katowice, Bytom, Poland.
⁸ Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, Massachusetts, USA.
⁹ Louisiana State University Health Sciences Center, Department of Anesthesiology, Shreveport, Louisiana, USA.
¹⁰ University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, Arizona, USA.
¹¹ Creighton University School of Medicine, Department of Anesthesiology, Omaha, Nebraska, USA.
¹² Valley Pain Consultants, Envision Physician Services, Phoenix, Arizona, USA.

Abstract

Introduction: In this study, two cases that demonstrate the importance of bedside echocardiography and hands-off telemedicine technology for diagnosis and intervention in patients with coronavirus disease 2019 (COVID-19) are discussed.

Case presentation: We report two cases of cardiac emergency associated with COVID-19. Case 1 is a 50-year-old female patient with chronic hypertension and chronic renal failure. Case 2 is a 64-year-old female with atrial fibrillation and recent stroke. Both were admitted to an isolation intensive care unit that was designated specifically to patients with COVID-19.

Conclusions: During admission, both patients had sudden deterioration characterized by oxygen desaturation and hypotension necessitating inotropic support. As a result, for both patients, bedside echocardiography was performed by the attending intensivist. Echocardiographic findings showed cardiac tamponade and acute pulmonary embolism, respectively, which were confirmed by a cardiologist through telemedicine technology. Proper emergency management was initiated, and both patients recovered well. Limited bedside transthoracic echocardiography had a front-line impact on the treatment and outcome of the two patients with COVID-19. By implementing telemedicine technology, the lives of two patients were saved, demonstrating the significance of telemedicine in isolation intensive care units in the developing countries during the COVID-19 pandemic.

Keywords: COVID-19; Cardiac Tamponade; Limited Echocardiography; Pulmonary Embolism; Telemedicine.

Publication types

Case Reports