Failure of Therapeutic Management in RBBB Myocardial Infarction Patients with Covid-19 Pneumonitis Admitted at Emergency Department of Tertiary Care Teaching Hospital a Case Series

ABSTRACT

Background:SARS-Cov-2(covid-19) infection is associated with Systemic Hyercoagulability and Thrombo-Embolic Complications. Anticoagulants play a key role in their management. Despite anticoagulants we have observed five case of RBBB MI in our ICU which co-relates with the thrombotic complication. And hence,Efficacy of the anticoagulants is debatable and requires meticulous APTT monitoring. Efficacy of thrombolysis is also not clear. A current guideline gives more emphasis on PCI over thrombolysis in RBBB MI patients. BUT unfortunate turn of events into catastrophe happened in these cases due to non-feasibility of cathlab interventions in covid-19 pandemic scenario. Material and Methods:This is A case series of five patients that were COVID-19 positive admitted to the ICU and Developed RBBB MI during their ICU stay despite on anticoagulant therapy. Data was collected retrospectively from hospital indoor records. Positive case of COVID-19 was confirmed by RT-PCR assay of nasopharyngeal or oropharyngeal swab specimen. Conclusion:Development of RBBB MI in covid-19 patients on anticoagulants co-relates with the thrombotic complication of SARS-CoV-2 infection and failure of the therapeutic management. PCI can be considered as a gold standard intervention compared to thrombolysis. BUT unfortunate turn of events into catastrophe happened in these cases due to non-feasibility of cathlab interventions in covid-19 pandemic scenario.