ABSTRACT
We present two cases of acute myocardial infarction in young patients with asymptomatic COVID-19 infection and ST-elevation myocardial infarction (STEMI), complicated by severe acute heart failure and ventricular fibrillation, resulting cardiopulmonary resuscitation and mechanical ventilatory support. Urgent primary percutaneous coronary intervention with further complex treatment was effective in both cases with critical cardiovascular state and co-morbid COVID-19 infection. This report illustrates the challenges in clinical severity of STEMI with COVID-19 infection, despite of young age and absence of clinical symptoms and chronic co-morbidities. STEMI patients with even asymptomatic COVID-19 infection may be presented with significantly higher rates of severe acute heart failure.