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Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Coronary Artery Disease III: Clinical Manifestations01:30

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Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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COVID-19 and ST elevations-keep an open mind: a case report.

Michael R Kendall1, Sridhar M Reddy1, Laura E Meinke1

  • 1Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA.

European Heart Journal. Case Reports
|January 13, 2021
PubMed
Summary

Pulmonary embolism (PE) can cause ST elevations mimicking heart attacks in COVID-19 patients. Prompt diagnosis and treatment of PE are crucial, especially in younger individuals without traditional cardiac risk factors.

Keywords:
COVID-19Case reportPulmonary embolismST elevationThrombolysis

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pulmonology

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to cardiovascular issues like myocardial injury and thromboembolism.
  • Pulmonary embolism (PE) can manifest as ST elevations, mimicking myocardial infarction due to right ventricular strain.

Purpose of the Study:

  • To highlight the association between COVID-19, pulmonary embolism, and ST-elevation myocardial infarction (STEMI)-like presentations.
  • To emphasize the importance of considering PE in COVID-19 patients presenting with ST elevations.

Main Methods:

  • Case report of a 48-year-old female with type 2 diabetes and hypertension presenting with COVID-19 symptoms.
  • Clinical presentation included respiratory failure, hypoxia, hypotension, and new ST elevations on ECG.
  • Diagnostic workup included echocardiography revealing right ventricular dilation and McConnell's sign.

Main Results:

  • The patient experienced ST elevations on ECG, indicative of potential myocardial infarction.
  • Echocardiography showed moderate right ventricular dilation and McConnell's sign, suggesting acute PE.
  • Treatment with tenecteplase led to complete resolution of ST elevations and improved oxygenation.

Conclusions:

  • Pulmonary embolism should be considered in the differential diagnosis for ST elevations in COVID-19 patients.
  • This is particularly important in younger patients with minimal coronary artery disease risk factors.
  • Early recognition and management of PE can prevent adverse cardiovascular outcomes in COVID-19.