Distinct Coagulopathy With Myocardial Injury and Pulmonary Embolism in COVID-19
| Autor: | Arnold N. Forlemu, Amro Aglan, Ayman R. Fath, Anup Solsi, Roxana N. Beladi, Kyle S. Varkoly, Nawfal Mihyawi, Abdullah S. Eldaly, Sharjeel Israr, Alexandra Lucas |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Medicine (General) Myocarditis Epidemiology Fulminant Case Report 030204 cardiovascular system & hematology Coronary Angiography coagulopathy STEMI 03 medical and health sciences Pericarditis Electrocardiography 0302 clinical medicine Fatal Outcome R5-920 Internal medicine medicine Coagulopathy Pathology Humans RB1-214 myocardial injury 030212 general & internal medicine Myocardial infarction Safety Risk Reliability and Quality micro-thrombotic emboli Ejection fraction business.industry SARS-CoV-2 SARS-CoV-2 infection COVID-19 Blood Coagulation Disorders Middle Aged medicine.disease Thrombosis Pulmonary embolism Cardiology ST Elevation Myocardial Infarction Radiography Thoracic business Pulmonary Embolism Safety Research |
| Zdroj: | Journal of Investigative Medicine High Impact Case Reports, Vol 9 (2021) Journal of Investigative Medicine High Impact Case Reports |
| ISSN: | 2324-7096 |
| Popis: | In this article, we report a case of a 61-year-old male who was diagnosed with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), presenting with acute respiratory distress syndrome requiring intubation and hemodynamic support, marked D-Dimer and troponin I elevation, worsening ST-elevation myocardial infarction on repeat electrocardiograms, and a negative coronary angiogram ruling out a coronary artery thrombosis or occlusion. With worsening diffuse ST-segment elevation on electrocardiograms and reduced ejection fraction on echocardiography in the setting of systemic inflammation, fulminant myocarditis was highly suspected. Despite optimal medical treatment, the patient’s condition deteriorated and was complicated by cardiac arrest that failed resuscitation. Although myocarditis was initially suspected, the autopsy revealed no evidence of myocarditis or pericarditis but did demonstrate multiple microscopic sites of myocardial ischemia together with thrombi in the left atrium and pulmonary vasculature. Additionally, scattered microscopic cardiomyocyte necrosis with pathological diagnosis of small vessel micro-thrombotic occlusions. These findings are potentially exacerbated by inflammation-induced coagulopathy, hypoxia, hypotension, and stress, that is, a multifactorial etiology. Further research and an improved understanding are needed to define the precise pathophysiology of the coagulopathic state causing widespread micro-thrombosis with subsequent myocardial and pulmonary injury. |
| Databáze: | OpenAIRE |
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