ABSTRACT
Data regarding angiographic characteristics, clinical profile, and inhospital outcomes of patients with coronavirus disease 2019 (COVID-19) referred for coronary angiography (CAG) are scarce. This is an observational study analyzing confirmed patients with COVID-19 referred for CAG from 10 European centers. We included 57 patients (mean age: 66 ± 15 years, 82% male) , of whom 18% had previous myocardial infarction (MI) and 29% had renal insufficiency and chronic pulmonary disease. ST-segment elevation myocardial infarction (STEMI) was the most frequent indication for CAG (58%). Coronavirus disease 2019 was confirmed after CAG in 86% and classified as mild in 49%, with 21% fully asymptomatic. A culprit lesion was identified in 79% and high thrombus burden in 42%; 7% had stent thrombosis. At 40 days follow-up, 16 (28%) patients experienced a major adverse cardiovascular event (MACE): 12 deaths (92% noncardiac), 1 MI, 2 stent thrombosis, and 1 stroke. In an European multicenter registry, patients with confirmed COVID-19 infection referred for CAG during the first wave of the severe acute respiratory syndrome coronavirus 2 pandemic presented mostly with STEMI and were predominantly males with comorbidities. Severity of COVID-19 was in general noncritical and 21% were asymptomatic at the time of CAG. Culprit coronary lesions with high thrombus burden were frequently identified, with a rate of stent thrombosis of 7%. The incidence of MACE at 40 days was high (28%), mostly due to noncardiac death.
Subject(s)
COVID-19 , Percutaneous Coronary Intervention , Aged , Aged, 80 and over , Coronary Angiography , Disease Outbreaks , Female , Humans , Male , Middle Aged , Registries , SARS-CoV-2 , Treatment OutcomeSubject(s)
Kounis Syndrome/epidemiology , Adrenal Cortex Hormones/therapeutic use , Aged , Anaphylaxis/complications , Anti-Allergic Agents/therapeutic use , Biomarkers , Comorbidity , Coronary Restenosis/complications , Coronary Vasospasm/complications , Critical Care , Disease Management , Disease Progression , Epinephrine/therapeutic use , Female , Humans , Incidence , Kounis Syndrome/drug therapy , Kounis Syndrome/etiology , Male , Middle Aged , Plaque, Atherosclerotic/complications , Retrospective Studies , Risk Factors , ST Elevation Myocardial Infarction/epidemiology , ST Elevation Myocardial Infarction/etiology , ST Elevation Myocardial Infarction/therapy , Stents/adverse effectsSubject(s)
Acute Coronary Syndrome , Electrocardiography , Arrhythmias, Cardiac , Humans , Myocardial InfarctionABSTRACT
Chest pain is one of the most frequent reasons for consulting in any healthcare setting, however its diagnosis remains a challenge for both Primary Care and Emergency Department physicians. We report a case of an Acute Aortic Syndrome which was diagnosed late after an insidious course of chest pain, repetitive syncope, and in which the delay in diagnosis and treatment could be fatal. We also describe the definition, diagnosis, treatment, and outcome of this condition.
Subject(s)
Aortic Diseases/diagnosis , Chest Pain/etiology , Acute Disease , Aged , Aortic Diseases/physiopathology , Delayed Diagnosis , Diagnosis, Differential , Humans , Male , SyndromeABSTRACT
El dolor torácico es uno de los motivos de consulta más frecuentes en cualquier ámbito sanitario, no obstante sigue suponiendo un reto diagnóstico tanto en la consulta del médico de atención primaria como en el ámbito de los médicos que prestan atención en los servicios de urgencias. Describimos un caso de síndrome aórtico agudo que se presentó de forma insidiosa en forma de dolor torácico y síncope de repetición en el que el retraso en el diagnóstico y tratamiento pudo resultar fatal. Hacemos también un breve repaso en la definición, diagnóstico, tratamiento y pronóstico de esta entidad (AU)
Chest pain is one of the most frequent reasons for consulting in any healthcare setting, however its diagnosis remains a challenge for both Primary Care and Emergency Department physicians. We report a case of an Acute Aortic Syndrome which was diagnosed late after an insidious course of chest pain, repetitive syncope, and in which the delay in diagnosis and treatment could be fatal. We also describe the definition, diagnosis, treatment, and outcome of this condition (AU)
Subject(s)
Humans , Male , Middle Aged , Aortic Arch Syndromes/complications , Aortic Arch Syndromes/diagnosis , Aortic Arch Syndromes/therapy , Chest Pain/complications , Chest Pain/diagnosis , Diagnosis, Differential , Hemostasis , Hemostasis, Surgical/trends , Echocardiography/methods , Echocardiography , Aortic Aneurysm/complications , Aortic Aneurysm , Aortic Dissection/complications , Aortic Dissection/diagnosis , Aortic Dissection/therapy , Primary Health Care/methods , Primary Health Care/trends , Doxazosin/therapeutic useABSTRACT
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