Non-ST Segment Elevation Myocardial Infarction in a Patient with COVID-19
Fahmi Othman1, Abdul Rehman Abid1, Mohammad Alibrahim1
1Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Insights
This case study highlights a patient with severe COVID-19 and coronary artery disease who experienced cardiac arrest. Prompt percutaneous coronary intervention led to a favorable outcome, demonstrating effective management strategies for COVID-19 related acute coronary syndrome.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) presents diverse cardiovascular (CV) complications, including acute coronary syndrome (ACS), myocarditis, and arrhythmias.
- Secondary cardiac involvement often results from systemic inflammation, manifesting as myocardial injury, biomarker elevation, or heart failure.
Observation:
- A 53-year-old male with pre-existing coronary artery disease developed severe COVID-19 pneumonia and adult respiratory distress syndrome requiring mechanical ventilation.
- During hospitalization, the patient experienced sudden cardiac arrest accompanied by diffuse ST-segment depression.
Findings:
- The patient underwent successful percutaneous coronary intervention to the left anterior descending artery for ST-segment depression following cardiac arrest.
- This intervention was crucial in managing the acute coronary syndrome precipitated by severe COVID-19.
Implications:
- This case underscores the importance of recognizing and managing acute coronary syndromes in COVID-19 patients, even in the context of severe respiratory illness.
- Early and appropriate cardiovascular interventions, such as percutaneous coronary intervention, can lead to favorable outcomes in critically ill COVID-19 patients with cardiac complications.
Abstract:
Coronavirus disease 2019 (COVID-19) is associated with a wide spectrum of cardiovascular (CV) manifestations. Primary cardiac manifestations of COVID-19 disease include acute coronary syndrome (ACS), myocarditis, and arrhythmias. Secondary cardiac involvement is usually due to a systemic inflammatory syndrome and can manifest as acute myocardial injury/biomarker elevation and/or heart failure (congestive heart failure). Elevated cardiac biomarkers indicate an unfavorable prognosis. Health-care systems of the world are rapidly learning more about the manifestations of COVID-19 on the CV system, as well as the strategies for the management of infected patients with CV disease. There is still a paucity of literature on the management of non-ST-segment elevation ACSs in the current literature. Herein, we report the case of a 53-year-old male patient, who presented with severe COVID-19 pneumonia deteriorating into adult respiratory distress syndrome requiring mechanical ventilation. The patient had a history of coronary artery disease. During the course of treatment, he developed sudden cardiac arrest with diffuse ST-segment depression, which was treated by percutaneous coronary intervention to the left anterior descending artery. The patient had a favorable outcome with excellent recovery from the disease.
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