Left ventricular free wall rupture as a result of delayed presentation of an inferior ST-elevation myocardial infarction due to fear of COVID-19: case report.

Autor: Nasr GH; Department of Medicine, University of California, Irvine, USA. gnasr@hs.uci.edu., Glovaci D; Department of Medicine, Division of Cardiology, University of California, Irvine, USA., Mikhail A; Department of Emergency Medicine, University of California, Irvine, USA., Sinfield S; Department of Medicine, University of California, Irvine, USA., Chen K; Department of Medicine, Division of Cardiology, University of California, Irvine, USA., Patel H; Department of Medicine, Division of Cardiology, University of California, Irvine, USA., Johl M; Department of Medicine, Division of Cardiology, University of California, Irvine, USA., Chakravarthy B; Department of Emergency Medicine, University of California, Irvine, USA., Singh S; Department of Anesthesia & Perioperative Care, University of California, Irvine, USA., Sagebin F; Department of Surgery, Division of Cardiothoracic Surgery, University of California, Irvine, USA., El-Farra AB; Department of Medicine, Division of Cardiology, University of California, Irvine, USA.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic surgery [J Cardiothorac Surg] 2021 Apr 22; Vol. 16 (1), pp. 106. Date of Electronic Publication: 2021 Apr 22.
DOI: 10.1186/s13019-021-01495-x
Abstrakt: Background: Left ventricular free wall rupture (LVFWR) is a rare complication after myocardial infarction and usually occurs 1 to 4 days after the infarct. Over the past decade, the overall incidence of LVFWR has decreased given the advancements in reperfusion therapies. However, during the COVID-19 pandemic, there has been a significant delay in hospital presentation of patients suffering myocardial infarctions, leading to a higher incidence of mechanical complications from myocardial infarctions such as LVFWR.
Case Presentation: We present a case in which a patient suffered a LVFWR as a mechanical complication from myocardial infarction due to delay in seeking care over fear of contracting COVID-19 from the medical setting. The patient had been having chest pain for a few days but refused to seek medical care due to fear of contracting COVID-19 from within the medical setting. He eventually suffered a cardiac arrest at home from a massive inferior myocardial infarction and found to be in cardiac tamponade from a left ventricular perforation. He was emergently taken to the operating room to attempt to repair the rupture but he ultimately expired on the operating table.
Conclusions: The occurrence of LVFWR has been on a more significant rise over the course of the COVID-19 pandemic as patients delay seeking care over fear of contracting COVID-19 from within the medical setting. Clinicians should consider mechanical complications of MI when patients present as an out-of-hospital cardiac arrest, particularly during the COVID-19 pandemic, as delay in seeking care is often the exacerbating factor.
Databáze: MEDLINE
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