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Acute Myocardial Infarction, Subclavian Vein Thrombosis, and Pulmonary Embolism Secondary to COVID-19-A Case Report.
Ivanova, Nevena Georgieva.
  • Ivanova NG; Department of Urology and General Medicine, Faculty of Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria.
Medicina (Kaunas) ; 59(4)2023 Mar 26.
Article in English | MEDLINE | ID: covidwho-2296980
ABSTRACT

Introduction:

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The majority of infected patients develop the clinical picture of a respiratory disease, although some may develop various complications, such as arterial or venous thrombosis. The clinical case presented herein is a rare example of sequential development and combination of acute myocardial infarction, subclavian vein thrombosis (Paget Schroetter syndrome), and pulmonary embolism in the same patient after COVID-19. Case presentation A 57-year-old man with a 10-day history of a SARS-CoV-2 infection was hospitalized with a clinical, electrocardiographic, and laboratory constellation of an acute inferior-lateral myocardial infarction. He was treated invasively and had one stent implanted. Three days after implantation, the patient developed shortness of breath and palpitation on the background of a swollen and painful right hand. The signs of acute right-sided heart strain observed on the electrocardiogram and the elevated D-dimer levels strongly suggested pulmonary embolism. A Doppler ultrasound and invasive evaluation demonstrated thrombosis of the right subclavian vein. The patient was administered pharmacomechanical and systemic thrombolysis and heparin infusion. Revascularization was achieved 24 h later via successful balloon dilatation of the occluded vessel.

Conclusion:

Thrombotic complications of COVID-19 can develop in a significant proportion of patients. Concomitant manifestation of these complications in the same patient is extremely rare, presenting at the same time, quite a therapeutic challenge to clinicians due to the need for invasive techniques and simultaneous administration of dual antiaggregant therapy combined with an anticoagulant treatment. Such a combined treatment increases the hemorrhagic risk and requires a serious accumulation of data for the purpose of a long-term antithrombotic prophylaxis in patients with such pathology.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Embolism / Thoracic Diseases / Venous Thrombosis / Upper Extremity Deep Vein Thrombosis / COVID-19 / Myocardial Infarction Type of study: Case report / Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Humans / Male / Middle aged Language: English Journal subject: Medicine Year: 2023 Document Type: Article Affiliation country: Medicina59040656

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Embolism / Thoracic Diseases / Venous Thrombosis / Upper Extremity Deep Vein Thrombosis / COVID-19 / Myocardial Infarction Type of study: Case report / Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Humans / Male / Middle aged Language: English Journal subject: Medicine Year: 2023 Document Type: Article Affiliation country: Medicina59040656