High thrombus burden despite thrombolytic therapy in ST-elevation myocardial infarction in a patient with COVID-19.
Rev Cardiovasc Med
; 21(2): 289-295, 2020 06 30.
Article
in English
| MEDLINE | ID: covidwho-676696
ABSTRACT
Consideration of thrombolysis as first-line reperfusion therapy in patients with COVID-19 and STEMI is recommended by ACC/SCAI guidelines. We describe a patient with COVID-19, who presented with ST-elevation myocardial infarction and was treated with thrombolysis and anticoagulation. He was later found to have a significant persistent thrombus burden requiring thrombectomy and stent placement. Invasive hemodynamics on multiple high-dose pressers revealed a high cardiac output state with low systemic vascular resistance, consistent with distributive rather than cardiogenic shock. Our case illustrates that thrombolytic therapy alone may not be adequate in patients with STEMI and COVID-19, as well as the importance of early invasive hemodynamics in management of shock in patient with STEMI and COVID-19 infection.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Coronary Thrombosis
/
Thrombolytic Therapy
/
Thrombectomy
/
Coronavirus Infections
/
ST Elevation Myocardial Infarction
Type of study:
Case report
Topics:
Long Covid
Limits:
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Rev Cardiovasc Med
Journal subject:
Vascular Diseases
/
Cardiology
Year:
2020
Document Type:
Article
Affiliation country:
J.rcm.2020.02.92
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