Early Postoperative Pulmonary Edema Attributable to Reverse Stress-Induced Cardiomyopathy in a Recently Infected COVID-19 Patient: A Case Report

The coronavirus disease 2019 (COVID-19) pandemic has increased the incidence of stress-induced cardiomyopathy (SICMP). A 33-year-old woman without any notable medical history underwent an emergency operation to treat a ruptured ectopic pregnancy. She entered hemorrhagic shock attributable to massive bleeding of the ruptured ectopic sac, followed by rapid transfusion and hydration, and vasopressor therapy. Her COVID-19 rapid antigen test was negative before surgery. After surgery, her vital signs were stable and she was mentally alert. However, about 1 hour later, she developed pulmonary edema, was re-intubated, and was admitted to the intensive care unit. There, echocardiography revealed reverse SICMP, and a COVID-19 polymerase chain reaction test was positive. She recovered well on conservative treatment. After 9 days, her echocardiography profile was normal and she was discharged without any cardiac symptoms or complications. Anesthesiologists should be aware that COVID-19-infected patients may develop postoperative SICMP.