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Coronary spasm and optical coherence tomography defined plaque erosion causing ST-segment-elevation acute myocardial
Masahiko Nakao1, Junji Matsuda1, Miho Iwai2
1Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Insights
Severe acute respiratory syndrome coronavirus 2 infection can cause acute myocardial infarction. In this case, coronary artery spasm and plaque erosion were identified as causes of myocardial infarction in a patient with COVID-19 pneumonia.
Area of Science:
- Cardiology
- Infectious Diseases
- Vascular Biology
Background:
- Coronavirus disease 2019 (COVID-19) is associated with various cardiovascular complications.
- Acute myocardial infarction (AMI) is a recognized, yet not fully understood, complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
- The specific mechanisms underlying AMI in COVID-19 patients require further elucidation.
Abstract:
An 84-year-old man with coronavirus disease 2019 pneumonia developed ST-segment-elevation myocardial infarction and was brought to the catheterization laboratory. His angiogram showed a haziness in distal right coronary artery, and optical coherence tomography (OCT) exhibited vascular spasm and OCT-defined plaque erosion, which were thought to be the causes of non-obstructive myocardial infarction. <Learning objective: Severe acute respiratory syndrome coronavirus 2 infection provokes various complications, which include acute myocardial infarction (AMI). Nevertheless, the mechanisms and characteristics of AMI in patients with coronavirus disease 2019 have not been elucidated. In the present case, coronary spasm and optical coherence tomography (OCT)-defined plaque erosion were confirmed as the substrates of coronary thrombosis by the findings of intracoronary OCT.>.
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