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Coronary and cerebral thrombosis in a young patient after mild COVID-19 illness: a case report

Lauren S Ranard1, David J Engel1, Ajay J Kirtane1

  • 1Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, New York, NY, USA.

European Heart Journal. Case Reports
|November 17, 2020
PubMed

Insights

Mild COVID-19 (coronavirus disease 2019) can lead to serious cardiac issues and blood clots. This case highlights the need for further research into post-COVID-19 thrombophilia and prophylaxis strategies.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Neurology

Background:

  • COVID-19 (coronavirus disease 2019) is a global pandemic associated with significant morbidity and mortality.
  • Myocardial injury and thromboembolism are recognized complications in severe COVID-19.
  • The risks of these complications in asymptomatic or mild COVID-19 cases remain largely unknown.

Observation:

  • A 35-year-old man with no prior cardiac history presented with chest pain and elevated troponin levels.
  • He had a history of mild, unspecified viral illness one month prior, later testing positive for SARS-CoV-2 antibodies.
  • Diagnostic workup revealed new cardiomyopathy, left ventricular thrombus, and coronary artery thrombosis, followed by a middle cerebral artery stroke.

Findings:

  • The patient experienced multiple thromboembolic events, including coronary artery and cerebral artery thrombosis, following a mild COVID-19 infection.
  • Cardiac evaluation demonstrated new-onset cardiomyopathy and thrombus formation.
  • Despite initial treatment, a second arterial thromboembolic event (stroke) occurred prior to discharge.

Implications:

  • Mild COVID-19 can precipitate significant cardiac injury and coagulopathy, even in young individuals without prior health conditions.
  • This case underscores the need for further investigation into the duration of thrombophilia post-COVID-19 recovery.
  • Guidelines are needed for thromboprophylaxis in specific populations and for determining the optimal duration of therapy after COVID-19.
Abstract

Keywords:
Acute coronary syndromeCOVID-19Case reportThrombo-embolism

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