Pharmaco-invasive Therapy for STEMI in a Patient with COVID-19: A Case Report
| Autor: | Apoorva Jayarangaiah, Samy I. McFarlane, Jonathan Francois, Nimrah A. Hossain, Naseem A. Hossain, Pramod Theetha Kariyanna, Moro O. Salifu, Jonathan D. Marmur |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Myocarditis medicine.medical_treatment Fulminant 030204 cardiovascular system & hematology Chest pain Systemic inflammation law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine Fibrinolysis medicine cardiovascular diseases 030212 general & internal medicine Myocardial infarction General Environmental Science business.industry medicine.disease Intensive care unit Respiratory failure Cardiology General Earth and Planetary Sciences medicine.symptom business |
| Zdroj: | American Journal of Medical Case Reports. 8:192-196 |
| ISSN: | 2374-2151 |
| Popis: | Coronavirus disease 2019 (COVID-19) is a pandemic that started in the Wuhan province of China in December 2019. It is associated with increased morbidity and mortality mainly due to severe acute respiratory syndrome 2 (SARS-Cov-2). Cardiac manifestations related to COVID-19 include demand ischemia, fulminant myocarditis, myocardial infarction and arrhythmias. In this report, we present a case of ST-segment elevation myocardial infarction (STEMI) in a 68-year-old man with COVID-19 who initially presented with chest pain and shortness of breath. Patient's STEMI was managed with pharmaco-invasive strategy with tissue plasminogen activator (t-PA). He then developed acute hypoxic respiratory failure that was managed in the intensive care unit (ICU), together with multi-organ failure from which the patient died 2 days after presentation. Although the pathophysiologic mechanisms of STEMI in COVID-19 patients has not been clearly established, we hypothesize that interrelated pathogenetic factors, that we highlight in this report, can play a role in the development of STEMI, including plaque rupture secondary to systemic inflammation, increased pro-coagulants, endothelial dysfunction, impaired fibrinolysis and impaired oxygen utilization leading to demand/ supply mismatch and myocardial ischemia. |
| Databáze: | OpenAIRE |
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