Ventricular Septal Rupture in 2 Patients Presenting Late after Myocardial Infarction during the COVID-19 Pandemic

Parikh, Malav; Busman, Meredith; Dickinson, Michael G.; Wohns, David; Madder, Ryan D.

doi:10.1016/j.jaccas.2020.07.023

Cited by 8 publications

(7 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Beyond reduction in incidence, delayed presentations have been more common during the first wave, 25,26 with increases in overall symptom-to-hospital delays 24,27 along with increased out of hospital cardiac arrest rates, 11 and anecdotal evidence of increased delayed presentations and mechanical complications. [16][17][18][19][20] However, the incidence of cardiogenic shock has not increased in a large Danish registry. 28 In one Canadian study, the incidence of STEMI admission was not reduced during the pandemic period in Montreal, but unstable STEMI presentations and worse in-hospital course was more frequent, 29 data that we could not replicate with a much larger and broader sample size.…”

Section: Discussionmentioning

confidence: 99%

“…Anecdotal evidence supports increased delayed or late presentations leading to increased mechanical complications. [16][17][18][19][20] The first wave of the COVID-19 pandemic has not occurred homogeneously throughout Canada. While the province of British Columbia (BC) was affected first, Quebec and Ontario experienced the greatest infection burden during the first wave of the pandemic.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The COVID-19 Pandemic and Coronary Angiography for ST-Elevation Myocardial Infarction, Use of Mechanical Support, and Mechanical Complications in Canada: A Canadian Association of Interventional Cardiology National Survey

Rinfret¹,

Jahan²,

McKenzie³

et al. 2021

CJC Open

View full text Add to dashboard Cite

Background As a result of the COVID-19 pandemic first wave, reductions in STEMI invasive care ranging from 23% to 76% have been reported from various countries. Whether it had any impact on coronary angiography (CA) volume or on mechanical support device use for ST-elevation myocardial infarction (STEMI) and post-STEMI mechanical complications in Canada is unknown. Methods We administered a Canada-wide survey to all Cardiac Catheterization Laboratory Directors seeking the volume of CA for STEMI performed during 01/03/2020-31/05/2020 (pandemic period) and from two control periods (01/03/2019-31/05/2019 and 01/03/2018-31/05/2018). The number of left ventricular support devices used, as well as the number of ventricular septal defects or papillary muscle rupture cases diagnosed, were also recorded. We also assessed if the number of COVID-19 cases recorded in each province was associated with STEMI CA volume. Results Forty-one out of 42 Canadian catheterization laboratories (98%) provided data. There was a modest but statistically significant 16% reduction (Incidence Rate Ratio or IRR 0.84; 95%CI 0.80-0.87) in CA for STEMI during the first wave of the pandemic compared to control periods. IRR was not associated with provincial COVID-19 caseload. We observed a 26% reduction (IRR 0.74; 95%CI 0.61-0.89) in the use of intra-aortic balloon pump in STEMI. Use of Impella® and mechanical complications from STEMI were exceedingly rare. Conclusion We observed a modest 16% decrease in CA for STEMI during the pandemic first wave in Canada, lower than reported in other countries. Provincial COVID-19 caseload did not influence this reduction.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The COVID-19 Pandemic and Coronary Angiography for ST-Elevation Myocardial Infarction, Use of Mechanical Support, and Mechanical Complications in Canada: A Canadian Association of Interventional Cardiology National Survey

Rinfret¹,

Jahan²,

McKenzie³

et al. 2021

CJC Open

View full text Add to dashboard Cite

show abstract

“…Mechanical complications following delayed MI presentations were described in a total of 26 case reports only (level of clinical evidence: IV) in 21 selected articles included in this study, dating from June 2020 to May 2021. 7 - 27 No gender predominance was noted as the male-to-female ratio was 1:1). The age of patients ranged from 37 to 87 years (mean ± standard deviation = 64.12 ± 53.70 years).…”

Section: Resultsmentioning

confidence: 97%

“…The data regarding patient demographics, presenting symptoms, time from symptom onset to presentation, electrocardiographic features, anatomic findings, nature of mechanical complications, left ventricular ejection fraction, treatment, and clinical outcomes are summarized ( Table 3 ). 7 - 27…”

Section: Resultsmentioning

confidence: 99%

Simultaneous Left Ventricular Aneurysm and Ventricular Septal Rupture Complicating Delayed STEMI Presentation: A Case-Based Review of Post-MI Mechanical Complications Amid the COVID-19 Pandemic

Goraya

Kalsoom

Almas

et al. 2021

Journal of Investigative Medicine High Impact Case Reports

View full text Add to dashboard Cite

Amid the coronavirus disease 2019 (COVID-19) pandemic, there is an unprecedented increase in public avoidance of hospitals predominantly driven by fear of contracting the virus. Recent publications highlight a re-emergence of rare post–myocardial infarction complications. While mechanical complications are infrequent in the era of primary percutaneous coronary intervention, they are associated with high mortality rates. The concurrent occurrence of mechanical complications such as left ventricular aneurysm and ventricular septal rupture is an extremely rare entity. We hereby delineate a unique case of a 53-year-old Caucasian male who underwent successful concomitant closure of a ventricular septal rupture, left ventricular aneurysmectomy, and 3-vessel coronary artery bypass grafting. Due to a delayed initial presentation owing to the patient’s fear of contracting COVID-19, the surgery was carried out 3 months after the myocardial infarction. His postoperative evaluation confirmed normal contractility of the left ventricle and complete closure of the ventricular septal rupture. Six months postoperatively, the patient continues to do well. We also present a literature review of the mechanical complications following delayed presentation of myocardial infarction amid the COVID-19 pandemic. This article illustrates that clinicians should remain cognizant of these extremely rare but potentially lethal collateral effects during the ongoing global public-health challenge. Furthermore, it highlights a significant concern regarding the delay in first medical contact due to the reluctance of patients to visit the hospital during the COVID-19 pandemic.

show abstract

“…1 Parikh et al reported two patients with late presenting AMI complicated by VSR. 4 One patient expired due to multi-organ failure despite mechanical circulatory support. Second patient underwent surgical repair after a failed percutaneous VSR closure.…”

Section: Introductionmentioning

confidence: 99%

Ventricular septal rupture and cardiogenic shock complicating STEMI during COVID-19 pandemic: An old foe re-emerges

et al. 2021

View full text Add to dashboard Cite

show abstract

Ventricular Septal Rupture in 2 Patients Presenting Late after Myocardial Infarction during the COVID-19 Pandemic

Cited by 8 publications

References 3 publications

The COVID-19 Pandemic and Coronary Angiography for ST-Elevation Myocardial Infarction, Use of Mechanical Support, and Mechanical Complications in Canada: A Canadian Association of Interventional Cardiology National Survey

The COVID-19 Pandemic and Coronary Angiography for ST-Elevation Myocardial Infarction, Use of Mechanical Support, and Mechanical Complications in Canada: A Canadian Association of Interventional Cardiology National Survey

Simultaneous Left Ventricular Aneurysm and Ventricular Septal Rupture Complicating Delayed STEMI Presentation: A Case-Based Review of Post-MI Mechanical Complications Amid the COVID-19 Pandemic

Ventricular septal rupture and cardiogenic shock complicating STEMI during COVID-19 pandemic: An old foe re-emerges

Contact Info

Product

Resources

About