Massive coronary thrombosis caused primary percutaneous coronary intervention to fail in a COVID-19 patient with ST-elevation myocardial infarction.
Catheter Cardiovasc Interv
; 97(5): E667-E669, 2021 04 01.
Article
in English
| MEDLINE | ID: covidwho-435007
ABSTRACT
COVID-19 is a new viral infection that has a significant impact on global health and economy. Because of its rapid spread worldwide, it may influence the prognosis of other medical conditions, such as ST-segment elevation myocardial infarction (STEMI). We report a case of a 58-year female patient admitted with an infero-posterior STEMI on the background of recently positive COVID-19 swab. Reperfusion was attempted through primary PCI but unfortunately failed to restore coronary blood flow due to massive thrombotic burden despite several attempts of balloon dilatation and aspiration thrombectomy. She sadly died later on because of hemodynamic deterioration. This scenario raises concerns about Neutrophil Extracellular Traps (NETS) which might potentially have propagated inflammation and thrombosis via platelets' aggregation leading to enhanced coagulopathy and massive coronary thrombosis. Therefore, we suggest primary PCI as the first-choice of revascularization in patients with combined COVID-19 and STEMI. Additionally, we emphasize on the importance of using the potent new generation P2Y12 inhibitors along with GPIIb/IIIa inhibitors in every STEMI patient with COVID-19 to achieve favorable conditions for primary PCI as well as favorable outcomes after stent implantation.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Coronary Thrombosis
/
Percutaneous Coronary Intervention
/
ST Elevation Myocardial Infarction
/
SARS-CoV-2
/
COVID-19
Type of study:
Case report
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Female
/
Humans
/
Middle aged
Language:
English
Journal:
Catheter Cardiovasc Interv
Journal subject:
Cardiology
Year:
2021
Document Type:
Article
Affiliation country:
Ccd.29050
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