RT Book, Section A1 Shrestha, Nikee A1 Shah, Niel A1 Ashraf, Shoaib A1 Jamshaid, Saria A2 Saad, Muhammad A2 Vittorio, Timothy J. SR Print(0) ID 1183948221 T1 Introduction to COVID-19 and Cardiovascular Disease T2 COVID-19 and the Heart: A Case-Based Pocket Guide YR 2022 FD 2022 PB McGraw Hill PP New York, NY SN 9781264266708 LK accesscardiology.mhmedical.com/content.aspx?aid=1183948221 RD 2024/03/29 AB A female patient in her late forties presented to the emergency department with neck swelling and pain on the right side for the last week. She had a significant past medical history of noninsulin-dependent diabetes mellitus, hypertension, morbid obesity, and iron deficiency anemia. The patient had a right internal jugular (IJ) tunneled catheter for iron infusions. She reported having a headache and myalgia 2 weeks prior, which she thought was the regular flu, and symptoms improved without any treatment. Her vital signs on admission were body temperature of 99.3°F, blood pressure of 139/77 mmHg, sinus tachycardia of 114 beats/min, respiratory rate of 17 breaths/min, and oxygen saturation of 98% on room air. Physical examination was unremarkable except right neck tenderness. A computed tomography (CT) scan of the neck and soft tissue with contrast showed the right IJ vein almost entirely thrombosed from its origin at the skull base to the right subclavian vein (Figure 1-1A). Meanwhile, CT scan of the chest showed diffuse ground-glass opacity within the lungs (Figure 1-1B). The right central vein subcutaneous port-a-cath access was removed, and she was begun on systemic anticoagulation with warfarin. Additional workup showed high factor VIII, D-dimer, low serum iron, and negative blood culture. The patient was suspected of having coronavirus disease 19 (COVID-19) as a cause of IJ thrombus. Anti-SARS-CoV-2 antibodies were done and reported positive.