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1.
Eur J Radiol ; 149: 110188, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1664888

ABSTRACT

SARS-CoV-2 infection, responsible for COVID-19 outbreak, can cause cardiac complications, worsening outcome and prognosis. In particular, it can exacerbate any underlying cardiovascular condition, leading to atherosclerosis and increased plaque vulnerability, which may cause acute coronary syndrome. We review current knowledge on the mechanisms by which SARS-CoV-2 can trigger endothelial/myocardial damage and cause plaque formation, instability and deterioration. The aim of this review is to evaluate current non-invasive diagnostic techniques for coronary arteries evaluation in COVID-19 patients, such as coronary CT angiography and atherosclerotic plaque imaging, and their clinical implications. We also discuss the role of artificial intelligence, deep learning and radiomics in the context of coronary imaging in COVID-19 patients.


Subject(s)
COVID-19 , Coronary Artery Disease , Plaque, Atherosclerotic , Artificial Intelligence , Coronary Angiography/methods , Coronary Artery Disease/diagnostic imaging , Coronary Vessels , Humans , Plaque, Atherosclerotic/diagnostic imaging , SARS-CoV-2
3.
Int J Cardiovasc Imaging ; 38(2): 447-456, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1527480

ABSTRACT

We aimed to examine the effect of a history of COVID-19 on myocardial ischemia in single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in patients who presented with shortness of breath and/or chest pain after recovery. For this single-center retrospective study, patients who presented at cardiology outpatient clinics and had SPECT-MPI were screened. A total of 1888 patients were included in the study, 340 of whom had a history of COVID-19. 64 patients with > 50% stenosis on coronary angiography were excluded from the study. The primary outcome of the study was abnormal MPI. In the study population, the median age was 56 (49-64 IQR) years, and 1127 (65%) of the patients were female. Abnormal MPI was detected in 77 patients (23%) in the COVID-19 group and in 244 patients (16%) in the non-COVID-19 group. After adjustment was performed for clinical predictors using Bayesian logistic regression, an important association was found between the presence of a confirmed prior COVID-19 infection and abnormal MPI (posterior median odds ratio, 1.70 [95% CrI, 1.20-2.40], risk difference, 9.6% [95% CrI, 1.8%, 19.7%]). In SPECT-MPI, ischemia rates were observed to be higher in COVID-19 group and it was found that a confirmed prior COVID-19 might predict of abnormal MPI.


Subject(s)
COVID-19 , Coronary Artery Disease , Myocardial Ischemia , Myocardial Perfusion Imaging , Bayes Theorem , COVID-19/complications , Coronary Angiography/methods , Coronary Artery Disease/diagnostic imaging , Female , Humans , Middle Aged , Myocardial Ischemia/diagnostic imaging , Myocardial Perfusion Imaging/methods , Predictive Value of Tests , Retrospective Studies , SARS-CoV-2 , Tomography, Emission-Computed, Single-Photon/methods
5.
Crit Care ; 25(1): 217, 2021 06 24.
Article in English | MEDLINE | ID: covidwho-1388810

ABSTRACT

BACKGROUND: The viral load of asymptomatic SAR-COV-2 positive (ASAP) persons has been equal to that of symptomatic patients. On the other hand, there are no reports of ST-elevation myocardial infarction (STEMI) outcomes in ASAP patients. Therefore, we evaluated thrombus burden and thrombus viral load and their impact on microvascular bed perfusion in the infarct area (myocardial blush grade, MBG) in ASAP compared to SARS-COV-2 negative (SANE) STEMI patients. METHODS: This was an observational study of 46 ASAP, and 130 SANE patients admitted with confirmed STEMI treated with primary percutaneous coronary intervention and thrombus aspiration. The primary endpoints were thrombus dimension + thrombus viral load effects on MBG after PPCI. The secondary endpoints during hospitalization were major adverse cardiovascular events (MACEs). MACEs are defined as a composite of cardiovascular death, nonfatal acute AMI, and heart failure during hospitalization. RESULTS: In the study population, ASAP vs. SANE showed a significant greater use of GP IIb/IIIa inhibitors and of heparin (p < 0.05), and a higher thrombus grade 5 and thrombus dimensions (p < 0.05). Interestingly, ASAP vs. SANE patients had lower MBG and left ventricular function (p < 0.001), and 39 (84.9%) of ASAP patients had thrombus specimens positive for SARS-COV-2. After PPCI, a MBG 2-3 was present in only 26.1% of ASAP vs. 97.7% of SANE STEMI patients (p < 0.001). Notably, death and nonfatal AMI were higher in ASAP vs. SANE patients (p < 0.05). Finally, in ASAP STEMI patients the thrombus viral load was a significant determinant of thrombus dimension independently of risk factors (p < 0.005). Thus, multiple logistic regression analyses evidenced that thrombus SARS-CoV-2 infection and dimension were significant predictors of poorer MBG in STEMI patients. Intriguingly, in ASAP patients the female vs. male had higher thrombus viral load (15.53 ± 4.5 vs. 30.25 ± 5.51 CT; p < 0.001), and thrombus dimension (4.62 ± 0.44 vs 4.00 ± 1.28 mm2; p < 0.001). ASAP vs. SANE patients had a significantly lower in-hospital survival for MACE following PPCI (p < 0.001). CONCLUSIONS: In ASAP patients presenting with STEMI, there is strong evidence towards higher thrombus viral load, dimension, and poorer MBG. These data support the need to reconsider ASAP status as a risk factor that may worsen STEMI outcomes.


Subject(s)
COVID-19/complications , Coronary Thrombosis/virology , Heart/physiopathology , Microcirculation/physiology , Myocardial Infarction/physiopathology , Aged , Analysis of Variance , Asymptomatic Infections/epidemiology , COVID-19/epidemiology , Cohort Studies , Coronary Angiography/methods , Coronary Thrombosis/epidemiology , Echocardiography/methods , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Myocardial Infarction/epidemiology
6.
Cardiovasc Ultrasound ; 19(1): 31, 2021 Aug 24.
Article in English | MEDLINE | ID: covidwho-1371970

ABSTRACT

BACKGROUND: Cardiovascular complications of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV2) are known to be associated with poor outcome. A small number of case series and reports have described cases of myocarditis and ischaemic events, however, knowledge on the aetiology of acute cardiac failure in SARS-CoV2 remains limited. We describe the occurrence and risk stratification imaging correlates of 'takotsubo' stress cardiomyopathy presenting in a patient with Coronavirus Disease 2019 (COVID-19) in the intensive care unit. An intubated 53-year old patient with COVID19 suffered acute haemodynamic collapse in the intensive care unit, and was thus investigated with transthoracic echocardiography (TTE), 12-lead electrocardiograms (ECG) and serial troponins and blood tests, and eventually coronary angiography due to clinical suspicion of ischaemic aetiology. Echocardiography revealed a reduced ejection fraction, with evident extensive apical akinesia spanning multiple coronary territories. Troponins and NT-proBNP were elevated, and ECG revealed ST elevation: coronary angiography was thus performed. This revealed no significant coronary stenosis. Repeat echocardiography performed within the following week revealed a substantial recovery of ejection fraction and wall motion abnormalities. Despite requirement of a prolonged ICU stay, the patient now remains clinically stable, and is on spontaneous breathing. CONCLUSION: This case report presents a case of takotsubo stress cardiomyopathy occurring in a critically unwell patient with COVID19 in the intensive care setting. Stress cardiomyopathy may be an acute cardiovascular complication of COVID-19 infection. In the COVID19 critical care setting, urgent bedside echocardiography is an important tool for initial clinical assessment of patients suffering haemodynamic compromise.


Subject(s)
COVID-19/epidemiology , Coronary Angiography/methods , Echocardiography/methods , Electrocardiography/methods , Takotsubo Cardiomyopathy/diagnosis , Comorbidity , Female , Humans , Middle Aged , Pandemics , Takotsubo Cardiomyopathy/epidemiology
7.
Tex Heart Inst J ; 48(3)2021 07 01.
Article in English | MEDLINE | ID: covidwho-1355273

ABSTRACT

During the coronavirus disease 2019 (COVID-19) pandmic, more patients are presenting with complications late after acute myocardial infarction. We report the case of a 71-year-old man who delayed seeking medical care for 2 weeks, despite progressive shortness of breath, cough, and tactile fever, for fear of contracting COVID-19 in the hospital. Clinical and echocardiographic evaluation revealed a ventricular septal rupture secondary to acute myocardial infarction. The patient underwent urgent cardiac catheterization, followed by successful saphenous vein grafting to the left anterior descending coronary artery and open surgical repair of the ventricular septal rupture with a bovine pericardial patch. This case highlights a potential long-lasting negative effect that the COVID-19 pandemic will have on the care-seeking behavior and health of patients with acute cardiovascular disease.


Subject(s)
COVID-19 , Cardiac Catheterization/methods , Coronary Artery Bypass/methods , Fear , Patient Acceptance of Health Care/psychology , ST Elevation Myocardial Infarction , Ventricular Septal Rupture , Aged , COVID-19/epidemiology , COVID-19/psychology , Coronary Angiography/methods , Echocardiography/methods , Electrocardiography/methods , Humans , Male , SARS-CoV-2 , ST Elevation Myocardial Infarction/complications , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/physiopathology , ST Elevation Myocardial Infarction/surgery , Time-to-Treatment/trends , Treatment Outcome , Ventricular Septal Rupture/diagnosis , Ventricular Septal Rupture/etiology , Ventricular Septal Rupture/physiopathology , Ventricular Septal Rupture/surgery
8.
Open Heart ; 8(1)2021 04.
Article in English | MEDLINE | ID: covidwho-1195855

ABSTRACT

BACKGROUND: The response to COVID-19 has required cancellation of all but the most urgent procedures; there is therefore a need for the reintroduction of a safe elective pathway. METHODS: This was a study of a pilot pathway performed at Barts Heart Centre for the admission of patients requiring elective coronary and structural procedures during the COVID-19 pandemic (April-June 2020). All patients on coronary and structural waiting lists were screened for procedural indications, urgency and adverse features for COVID-19 prognosis and discussed at dedicated multidisciplinary teams. Dedicated admission pathways involving preadmission isolation, additional consent, COVID-19 PCR testing and dedicated clean areas were used. RESULTS: 143 patients (101 coronary and 42 structural) underwent procedures (coronary angiography, percutaneous coronary intervention, transcatheter aortic valve intervention and MitralClip) during the study period. The average age was 68.2; 74% were male; and over 93% had one or more moderate COVID-19 risk factors. All patients were COVID-19 PCR negative on admission with (8.1%) COVID-19 antibody positive (swab negative). All procedures were performed successfully with low rates of procedural complications (9.8%). At 2-week follow-up, no patients had symptoms or confirmed COVID-19 infection with significant improvements in quality if life and symptoms. CONCLUSION: We demonstrated that patients undergoing coronary and structural procedures can be safely admitted during the COVID-19 pandemic, with no patients contracting COVID-19 during their admission. Reassuringly, patients reflective of typical practice, that is, those at moderate or higher risk, were treated successfully. This pilot provides important information applicable to other settings, specialties and areas to reintroduce services safely.


Subject(s)
COVID-19 , Cardiology Service, Hospital/organization & administration , Coronary Angiography/methods , Elective Surgical Procedures , Heart Valve Prosthesis Implantation/methods , Infection Control , Percutaneous Coronary Intervention/methods , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing , Elective Surgical Procedures/methods , Elective Surgical Procedures/statistics & numerical data , Elective Surgical Procedures/trends , Female , Humans , Infection Control/methods , Infection Control/organization & administration , Male , Organizational Innovation , Outcome and Process Assessment, Health Care , Risk Adjustment/methods , SARS-CoV-2 , Safety Management/organization & administration , United Kingdom/epidemiology
10.
BMJ Case Rep ; 14(3)2021 Mar 24.
Article in English | MEDLINE | ID: covidwho-1150217

ABSTRACT

A 34-year-old man presented with central chest pain heralded by bilateral arm numbness, tingling and pain soon after donation of 1000 mL of COVID-19 convalescent plasma (CP). ECG showed ST-elevation in lateral leads and coronary angiogram showed large thrombus in diagonal branch of the left anterior descending artery. The patient underwent successful thrombus aspiration and percutaneous coronary intervention of diagonal branch. In this report, we describe a case of coronary thrombosis leading to ST-elevation myocardial infarction in a naïve plasma donor after donation of COVID-19 CP.


Subject(s)
Blood Donors , COVID-19/therapy , Coronary Thrombosis/complications , ST Elevation Myocardial Infarction/etiology , Adult , COVID-19/blood , Coronary Angiography/methods , Coronary Thrombosis/diagnosis , Coronary Thrombosis/therapy , Electrocardiography/methods , Humans , Immunization, Passive/adverse effects , Male , Percutaneous Coronary Intervention/methods , Plasma , SARS-CoV-2 , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/therapy , Thrombectomy/methods , Treatment Outcome
11.
Open Heart ; 8(1)2021 03.
Article in English | MEDLINE | ID: covidwho-1140343

ABSTRACT

OBJECTIVES: CT coronary angiography (CTCA) is a well-validated clinical tool in the evaluation of chest pain. In our institution, CTCA availability was increased in January 2020, and subsequently, expanded further to replace all exercise testing during the COVID-19 pandemic. Our objective was to assess the impact of increased utilisation of CTCA on length of stay in patients presenting with chest pain in the prepandemic era and during the COVID-19 pandemic. METHODS: Study design was retrospective. Patients referred for cardiology review between October 2019 and May 2020 with chest pain and/or dyspnoea were broken into three cohorts: a baseline cohort, a cohort with increased CTCA availability and a cohort with increased CTCA availability, but after the national lockdown due to COVID-19. Coronary angiography and revascularisation, length of stay and 30-day adverse outcomes were assessed. RESULTS: 513 patients (35.3% female) presented over cohorts 1 (n=179), 2 (n=182), and 3 (n=153). CTCA use increased from 7.8% overall in cohort 1% to 20.4% in cohort 3. Overall length of stay for the patients undergoing CTCA decreased from a median of 4.2 days in cohort 1 to 2.5 days in cohort 3, with no increase in 30 days adverse outcomes. Invasive coronary angiogram rates were 45.8%, 39% and 34.2% across the cohorts. 29.6% underwent revascularisation in cohort 1, 15.9% in cohort 2 and to 16.4% in cohort 3. CONCLUSIONS: Increased CTCA availability was associated with a significantly reduced length of stay both pre-COVID-19 and post-COVID-19 lockdown, without any increase in 30-day adverse outcomes.


Subject(s)
Acute Pain/diagnosis , COVID-19/epidemiology , Chest Pain/diagnosis , Computed Tomography Angiography/methods , Coronary Angiography/methods , Emergency Service, Hospital , Inpatients , Acute Pain/epidemiology , Aged , Chest Pain/epidemiology , Female , Follow-Up Studies , Humans , Ireland/epidemiology , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2
12.
Heart ; 107(9): 734-740, 2021 05.
Article in English | MEDLINE | ID: covidwho-1123608

ABSTRACT

OBJECTIVE: There are concerns that healthcare and outcomes of black, Asian and minority ethnic (BAME) communities are disproportionately impacted by the COVID-19 pandemic. We investigated admission rates, treatment and mortality of BAME with acute myocardial infarction (AMI) during COVID-19. METHODS: Using multisource national healthcare records, patients hospitalised with AMI in England during 1 February-27 May 2020 were included in the COVID-19 group, whereas patients admitted during the same period in the previous three consecutive years were included in a pre-COVID-19 group. Multilevel hierarchical regression analyses were used to quantify the changes in-hospital and 7-day mortality in BAME compared with whites. RESULTS: Of 73 746 patients, higher proportions of BAME patients (16.7% vs 10.1%) were hospitalised with AMI during the COVID-19 period compared with pre-COVID-19. BAME patients admitted during the COVID-19 period were younger, male and likely to present with ST-elevation acute myocardial infarction. COVID-19 BAME group admitted with non-ST-elevation acute myocardial infarction less frequently received coronary angiography (86.1% vs 90.0%, p<0.001) and had a longer median delay to reperfusion (4.1 hours vs 3.7 hours, p<0.001) compared with whites. BAME had higher in-hospital (OR 1.68, 95% CI 1.27 to 2.28) and 7-day mortality (OR 1.81 95% CI 1.31 to 2.19) during COVID-19 compared with pre-COVID-19 period. CONCLUSION: In this multisource linked cohort study, compared with whites, BAME patients had proportionally higher hospitalisation rates with AMI, less frequently received guidelines indicated care and had higher early mortality during COVID-19 period compared with pre-COVID-19 period. There is a need to develop clinical pathways to achieve equity in the management of these vulnerable populations.


Subject(s)
COVID-19 , Critical Pathways , Healthcare Disparities , Non-ST Elevated Myocardial Infarction , ST Elevation Myocardial Infarction , COVID-19/mortality , COVID-19/therapy , Coronary Angiography/methods , Coronary Angiography/statistics & numerical data , Critical Pathways/organization & administration , Critical Pathways/standards , England/epidemiology , Female , Health Services Needs and Demand , Healthcare Disparities/standards , Healthcare Disparities/statistics & numerical data , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Non-ST Elevated Myocardial Infarction/ethnology , Non-ST Elevated Myocardial Infarction/therapy , Outcome and Process Assessment, Health Care , Race Factors , SARS-CoV-2 , ST Elevation Myocardial Infarction/ethnology , ST Elevation Myocardial Infarction/therapy
14.
PLoS One ; 15(12): e0244707, 2020.
Article in English | MEDLINE | ID: covidwho-999850

ABSTRACT

BACKGROUND: Since the outbreak of the COVID-19 pandemic, a number of risk factors for a poor outcome have been identified. Thereby, cardiovascular comorbidity has a major impact on mortality. We investigated whether coronary calcification as a marker for coronary artery disease (CAD) is appropriate for risk prediction in COVID-19. METHODS: Hospitalized patients with COVID-19 (n = 109) were analyzed regarding clinical outcome after native computed tomography (CT) imaging for COVID-19 screening. CAC (coronary calcium score) and clinical outcome (need for intensive care treatment or death) data were calculated following a standardized protocol. We defined three endpoints: critical COVID-19 and transfer to ICU, fatal COVID-19 and death, composite endpoint critical and fatal COVID-19, a composite of ICU treatment and death. We evaluated the association of clinical outcome with the CAC. Patients were dichotomized by the median of CAC. Hazard ratios and odds ratios were calculated for the events death or ICU or a composite of death and ICU. RESULTS: We observed significantly more events for patients with CAC above the group's median of 31 for critical outcome (HR: 1.97[1.09,3.57], p = 0.026), for fatal outcome (HR: 4.95[1.07,22.9], p = 0.041) and the composite endpoint (HR: 2.31[1.28,4.17], p = 0.0056. Also, odds ratio was significantly increased for critical outcome (OR: 3.01 [1.37, 6.61], p = 0.01) and for fatal outcome (OR: 5.3 [1.09, 25.8], p = 0.02). CONCLUSION: The results indicate a significant association between CAC and clinical outcome in COVID-19. Our data therefore suggest that CAC might be useful in risk prediction in patients with COVID-19.


Subject(s)
COVID-19/pathology , Coronary Artery Disease/diagnostic imaging , Vascular Calcification/diagnostic imaging , Vascular Calcification/diagnosis , Aged , COVID-19/diagnostic imaging , COVID-19/therapy , Coronary Angiography/methods , Coronary Artery Disease/pathology , Female , Germany , Humans , Male , Middle Aged , SARS-CoV-2 , Tomography, X-Ray Computed/methods , Treatment Outcome , Vascular Calcification/pathology
17.
Can J Cardiol ; 37(6): 887-894, 2021 06.
Article in English | MEDLINE | ID: covidwho-898623

ABSTRACT

BACKGROUND: Left main coronary arterial (LMCA) atresia is a rare coronary arterial anomaly with extremely limited data on the optimal management. We aimed to report our single-surgeon experience of the ostioplasty in patients with LMCA atresia. METHODS: From July 2018 to December 2019, pediatric patients who presented with LMCA atresia and subsequently underwent surgical coronary ostioplasty were recruited into this retrospective study. Concomitant mitral repair was applied when the regurgitation was moderate or more severe. RESULTS: A total of 9 patients diagnosed with LMCA atresia were included. Mitral regurgitation was found in all of them, including 6 (66.7%) severe, 1 (11.1%) moderate, and 2 (22.2%) mild. In addition to ischemic lesions, which were found in 7 (77.8%) patients, structural mitral problems were also common (presented in 7 [77.8%] patients). All the patients underwent coronary ostioplasty with autologous pulmonary arterial patch augmenting the anterior wall of the neo-ostium. Mean aortic cross clamp time and cardiopulmonary bypass time was 88.1 ± 18.9 and 124.6 ± 23.6 minutes, respectively. During a median of 10.9 (range: 3.3 to 17.2) months' follow-up, there was only 1 death at 5 months after surgery. All survivors were recovered uneventfully with normal left-ventricular function; however, with 4 (50.0%) having significant recurrence of mitral regurgitation. CONCLUSIONS: With favourable surgical outcomes, coronary ostioplasty for LMCA atresia may be an option of revascularization. Structural mitral problems presented in majority patients, resulting in the requirement of concomitant mitral repair. However, the optimal technique of mitral repair remains unclear.


Subject(s)
Angioplasty/methods , Coronary Artery Disease , Coronary Vessel Anomalies , Mitral Valve Annuloplasty , Mitral Valve Insufficiency , Pulmonary Artery/transplantation , Aorta, Thoracic/surgery , Child, Preschool , Coronary Angiography/methods , Coronary Artery Disease/complications , Coronary Artery Disease/congenital , Coronary Artery Disease/surgery , Coronary Vessel Anomalies/complications , Coronary Vessel Anomalies/diagnosis , Coronary Vessel Anomalies/surgery , Female , Humans , Male , Mitral Valve Annuloplasty/adverse effects , Mitral Valve Annuloplasty/methods , Mitral Valve Insufficiency/complications , Mitral Valve Insufficiency/diagnosis , Mitral Valve Insufficiency/surgery , Myocardial Revascularization/methods , Operative Time , Recurrence , Transplantation, Autologous/methods , Treatment Outcome
19.
Am J Case Rep ; 21: e926101, 2020 Sep 28.
Article in English | MEDLINE | ID: covidwho-802888

ABSTRACT

BACKGROUND The novel coronavirus disease (COVID-19) has been declared a pandemic. With the ever-increasing number of COVID-19 patients, it is imperative to explore the factors related to the disease to aid patient management until a definitive vaccine is ready, as the disease is not limited to the respiratory system alone. COVID-19 has been associated with various cardiovascular complications including acute myocardial injury, myocarditis, arrhythmias, and venous thromboembolism. The infection is severe in patients with pre-existing cardiovascular disease, and a systemic inflammatory response due to a cytokine storm in severe COVID-19 cases can lead to acute myocardial infarction. CASE REPORT We present the case of a 56-year-old man with cardiovascular risk factors including coronary artery disease, hypertension, ischemic cardiomyopathy, and hyperlipidemia, who had COVID-19-induced pneumonia complicated with acute respiratory distress syndrome. He subsequently developed myocardial infarction during his hospitalization at our facility. He had a significant contact history for COVID-19. He was managed with emergent cardiac revascularization after COVID-19 was confirmed by real-time reverse transcription-polymerase chain reaction testing from a nasopharyngeal swab as per hospital policy for admitted patients. Apart from dual antiplatelet therapy, tocilizumab therapy was initiated due to the high interleukin-6 levels. His hospitalization was complicated by hemodialysis and failed extubation and intubation, resulting in a tracheostomy. Upon improvement, he was discharged to a long-term facility with a plan for outpatient follow-up. CONCLUSIONS In high-risk patients with COVID-19-induced pneumonia and cardiovascular risk factors, a severe systemic inflammatory response can lead to atherosclerotic plaque rupture, which can manifest as acute coronary syndrome.


Subject(s)
Coronavirus Infections/complications , Inferior Wall Myocardial Infarction/complications , Inferior Wall Myocardial Infarction/therapy , Percutaneous Coronary Intervention/methods , Pneumonia, Viral/complications , Severe Acute Respiratory Syndrome/complications , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/methods , Coronary Angiography/methods , Coronavirus Infections/diagnosis , Critical Illness , Follow-Up Studies , Humans , Inferior Wall Myocardial Infarction/diagnostic imaging , Long-Term Care/methods , Male , Middle Aged , Multimorbidity , Pandemics , Pneumonia, Viral/diagnosis , Respiration, Artificial/methods , Risk Assessment , Severe Acute Respiratory Syndrome/diagnosis , Severe Acute Respiratory Syndrome/therapy , Time Factors , Tracheostomy/methods , Treatment Outcome
20.
Curr Probl Cardiol ; 46(3): 100716, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-796936

ABSTRACT

During the coronavirus disease 2019 (COVID-19) pandemic, strained acute care resources, the potential for rapid clinical decompensation, and concerns about staff safety has prompted a conservative management approach for acute coronary syndrome patients. We present our experience of COVID-19 patients at Elmhurst Hospital Center presenting with ST-Elevation Myocardial Infarction and compared outcomes of invasive vs conservative treatment strategies.


Subject(s)
COVID-19/epidemiology , Coronary Angiography/methods , Disease Management , Pandemics , Percutaneous Coronary Intervention/methods , Risk Assessment/methods , ST Elevation Myocardial Infarction/therapy , Female , Humans , Male , Middle Aged , SARS-CoV-2 , ST Elevation Myocardial Infarction/epidemiology , Time Factors , United States/epidemiology
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