Streptokinase in a COVID-19-positive patient with STEMI in a PPCI centre: a local experience

Area of Science:

• Cardiology
• Infectious Diseases
• Critical Care Medicine

Background:

• Primary percutaneous coronary intervention is the standard treatment for ST-elevation myocardial infarction (STEMI).
• The COVID-19 pandemic has led to varied international guidelines for STEMI management.
• Healthcare systems face challenges including staff shortages and limited negative-pressure catheterization laboratories.

Observation:

• A SARS-CoV-2 positive patient with pneumonia developed inferoposterior wall myocardial infarction (MI).
• The patient was hemodynamically stable and did not require immediate invasive procedures.
• Treatment with thrombolytics (streptokinase) was initiated without complications.

Findings:

• Successful treatment of STEMI with thrombolytics in a COVID-19 positive patient.
• Thrombolytic therapy was effective in managing myocardial infarction without severe adverse events.
• This case demonstrates a viable alternative to primary PCI in specific pandemic-related circumstances.

Implications:

• Thrombolytics may be a valuable treatment option for low-risk, hemodynamically stable MI patients during the COVID-19 pandemic.
• Using thrombolytics can reduce in-hospital exposure to SARS-CoV-2 for healthcare staff.
• Further research is needed to establish international consensus on thrombolytic use for STEMI in pandemic settings.