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Inferior Wall Myocardial Infarction in Severe COVID-19 Infection: A Case Report.
Sheikh, Abu Baker; Shekhar, Rahul; Javed, Nismat; Upadhyay, Shubhra.
  • Sheikh AB; Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
  • Shekhar R; Division of Hospital Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
  • Javed N; Department of Internal Medicine, Shifa College of Medicine, Islamabad, Pakistan.
  • Upadhyay S; Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Severe Acute Respiratory Syndrome / Inferior Wall Myocardial Infarction / Percutaneous Coronary Intervention Type of study: Case report / Cohort study / Diagnostic study / Prognostic study Topics: Long Covid / Vaccines Limits: Humans / Male / Middle aged Language: English Journal: Am J Case Rep Year: 2020 Document Type: Article Affiliation country: Ajcr.926101

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Severe Acute Respiratory Syndrome / Inferior Wall Myocardial Infarction / Percutaneous Coronary Intervention Type of study: Case report / Cohort study / Diagnostic study / Prognostic study Topics: Long Covid / Vaccines Limits: Humans / Male / Middle aged Language: English Journal: Am J Case Rep Year: 2020 Document Type: Article Affiliation country: Ajcr.926101