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Unusual presentations of cardiac rupture during COVID-19 pandemic

Norberto Gustavo Allende1,2, Ramiro Santos2, Fernando Jose Sokn1

  • 1Clinica IMA, Adrogue, Argentina.

Echocardiography (Mount Kisco, N.Y.)
|February 18, 2021
PubMed

Insights

The COVID-19 pandemic delayed acute coronary syndrome treatment, leading to late hospital arrivals and increased cardiac rupture complications. This report details two unusual cardiac rupture cases: left ventricular pseudoaneurysm and intramyocardial dissecting hematoma.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Public Health

Background:

  • The COVID-19 pandemic has led to decreased hospitalizations for acute coronary syndrome.
  • Delayed medical attention seeking has increased among patients experiencing cardiac events.
  • Patients with ST segment elevation myocardial infarction are presenting later for treatment.

Observation:

  • Two patients presented with unusual cardiac rupture complications.
  • These complications included left ventricular pseudoaneurysm and left ventricular intramyocardial dissecting hematoma.
  • These conditions are reminiscent of pre-reperfusion strategy eras.

Findings:

  • Detailed imaging evaluation revealed the specific nature of the cardiac ruptures.
  • The cases highlight a resurgence of mechanical complications typically seen decades ago.
  • Late presentation precluded timely reperfusion strategies for these patients.

Implications:

  • The findings underscore the critical impact of delayed care on myocardial infarction outcomes.
  • Increased frequency of mechanical cardiac complications necessitates heightened awareness and proactive management.
  • Urgent strategies are needed to mitigate the adverse cardiovascular consequences of the pandemic.

Keywords:
left ventricular pseudoaneurysmleft ventricular thrombimyocardial infarctionmyocardial rupture

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