Coronavirus disease 2019 (COVID-19) and simultaneous acute anteroseptal and inferior ST-segment elevation myocardial
Mustafa Yolcu1, Fusun Gunesdogdu2, Metin Bektas3
1Department of Cardiology, Faculty of Medicine, Istanbul Yeni Yuzyil University, Gaziosmanpasa Hospital, Gaziosmanpasa, Istanbul, Turkey.
Insights
This case study highlights a rare instance of simultaneous acute ST-elevation myocardial infarction (STEMI) in both inferior and anterior heart regions in a patient with COVID-19. The findings suggest a potential link between severe COVID-19 infection and complex cardiac events like STEMI.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) is a global pandemic with significant mortality.
- Acute ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular emergency requiring prompt treatment.
- Co-occurrence of COVID-19 and STEMI presents unique clinical challenges.
Observation:
- A patient with pre-existing diabetes mellitus and hypertension presented with symptoms consistent with COVID-19.
- The patient tested positive for COVID-19 and later developed acute chest pain.
- Electrocardiography revealed simultaneous acute inferior and anterior STEMI.
Findings:
- The patient experienced two distinct STEMI events affecting different coronary arteries concurrently.
- COVID-19 infection was confirmed via PCR testing.
Implications:
- COVID-19 may trigger severe cardiovascular events like multiple STEMIs, even in patients with known risk factors.
- Elevated physiological stress and metabolic demand during COVID-19 infection could precipitate acute coronary thrombosis.
- This case emphasizes the need for vigilant cardiac monitoring in COVID-19 patients, particularly those with comorbidities.
Abstract:
Coronavirus disease 2019 (COVID-19) is a recently recognised pandemic spreading rapidly from Wuhan, Hubei, to other provinces in China and to many countries around the world. The number of COVID-19-related deaths is steadily increasing. Acute ST-segment elevation myocardial infarction (STEMI) is a disease with high morbidity and mortality rates, and primary percutaneous coronary intervention is usually recommended for the treatment. A patient with diabetes mellitus and hypertension for five years was admitted to the emergency unit with symptoms of fever, cough and dyspnoea. These symptoms were consistent with viral pneumonia and a COVID PCR test was performed, which tested positive three days later. The patient had chest pain on the eighth day of hospitalisation. On electrocardiography, simultaneous acute inferior and anterior STEMI were identified. High levels of stress and increased metabolic demand in these patients may lead to concomitant thrombosis of different coronary arteries, presenting with two different STEMIs.
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