A Unique Case of COVID-19-related Acute Coronary Thrombosis Complicated by Severe Hypokalemia

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Updated: Nov 12, 2025

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

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Matthew Lavoie1, Ariana Ramirez1, Jeffrey Kunz1

  • 1Department of Internal Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, WA 98431, USA.

Military Medicine
|March 16, 2021
PubMed

Insights

This case study highlights a rare presentation of coronavirus disease-2019 (COVID-19) leading to cardiac arrest from acute coronary thrombosis and severe hypokalemia. Prompt intervention with percutaneous coronary intervention and potassium repletion proved life-saving.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Nephrology

Background:

  • Coronavirus disease-2019 (COVID-19) has been associated with various cardiovascular complications.
  • The renin-angiotensin-aldosterone system (RAAS) plays a crucial role in cardiovascular homeostasis and electrolyte balance.

Observation:

  • A 52-year-old male with symptomatic COVID-19 presented with ventricular tachycardia/fibrillation cardiac arrest, ST-elevation myocardial infarction, and profound hypokalemia.
  • This presentation suggests a potential link between COVID-19 infection and both acute coronary thrombosis and severe electrolyte disturbances.

Findings:

  • The patient's cardiac arrest was attributed to a combination of acute coronary thrombosis and severe hypokalemia.
  • Successful management involved primary percutaneous coronary intervention and aggressive potassium repletion.

Implications:

  • This case underscores the complex cardiovascular manifestations of COVID-19, including thrombotic events and hypokalemia.
  • Understanding COVID-19's impact on the RAAS may be key to recognizing and managing hypokalemic presentations.
  • Further research is warranted to elucidate the mechanisms linking COVID-19 to these critical cardiovascular events.

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