Management of a patient presenting with anterior STEMI with concomitant COVID‐19 infection early in the course of the U.S. pandemic

Abstract

The coronavirus disease‐2019 (COVID‐19) is a viral illness with heterogenous clinical manifestations, ranging from mild symptoms to severe acute respiratory distress syndrome and shock caused by the severe acute respiratory syndrome coronavirus‐2. The global healthcare community is rapidly learning more about the effects of COVID‐19 on the cardiovascular system, as well as the strategies for management of infected patients with cardiovascular disease. There is minimal literature available surrounding the relationship between COVID‐19 infection and acute coronary syndrome. We describe the case of a woman who presented with an acute anterior ST‐elevation myocardial infarction managed by primary percutaneous coronary intervention, who subsequently developed severe COVID‐19 infection and ultimately succumbed to multisystem organ failure.

Myocardial Injury on CMR in Patients With COVID-19 and Suspected Cardiac Involvement

“…1 Although it is well known that COVID-19 results in significant pulmonary disease, several studies have shown that infection with SARS-CoV-2 is also associated with myocardial injury. 2 , 3 , 4 , 5 Prior studies have reported heterogeneous cardiac manifestations, including myocarditis, 6 , 7 , 8 , 9 , 10 myocardial infarction (MI), 11 , 12 , 13 arrhythmias, 2 , 14 , 15 stress cardiomyopathy, 7 , 16 , 17 and cardiogenic shock. 18 Although the precise pathophysiological mechanisms of myocardial injury remain unclear, 19 it is well established that myocardial injury in patients with COVID-19 is associated with increased morbidity.…”

Cardiac Complications in Patients with COVID-19: An Integrative Literature Review

“…According to Table 3, the cardiac complications described by the authors of the selected articles were arrhythmias (1,2,15,28,31,32), changes in the conduction of the electrical impulse generated by the physiological pacemaker of the heart; acute heart injury (1,7,8,12,17,32), myocardial injury (2), coronary heart disease (14,(31)(32)(33)(34), obstructive coronary disease (15,16,28,30,31) and heart failure (15,28,32).…”

“…The obstructive events predominantly represented by acute myocardial infarction are possibly the result of an increased myocardial workload during infections, which cause myocardial injuries (37,(38)(39)(40). In addition, Sars-CoV-2 has been shown to trigger an exaggerated systemic inflammatory response, which, in addition to acute lung injury and acute respiratory distress syndrome, can lead to multiple cardiovascular complications (32,34), unstable angina, tachycardia, heart failure, stroke, cardiogenic shock and even cardiopulmonary arrest (37,39). Table 3 shows the data related to the selected studies, according to the authors, database, title, journal, study location, objectives, methodological design, and complications.…”

“…The progressive increase in the biomarkers, in addition to indicating coronary obstructive events, can signal the development of systemic complications, such as disseminated intravascular coagulation (45,46). This finding considerably raises the mortality rates due to COVID-19 (8,12), especially in patients with a previous history of SAH, DM, dyslipidemia and/or CAD (16,33,34,38). From this perspective, it can be said that CVDs are considered important risk factors for the occurrence of cardiac complications during hospitalization, increasing the potential for severity and deaths, especially in aged patients (15,29,30,31,32,33,38).…”

Thrombosis management and challenges in COVID-19 patients presenting with acute coronary syndromes

“…[ 54 ] There is only a limited number of case reports which had discussed the management of COVID-19 patients presenting with Type 1 MI. [ 63 64 65 66 67 68 69 70 71 72 73 74 75 76 ]…”