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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Coronary artery thrombus resulting in ST-elevation myocardial infarction in a patient with COVID-19

Clara Green1, Adnan Nadir2, Will Lester3

  • 1Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK clara.green@nhs.net.

BMJ Case Reports
|August 26, 2021
PubMed

Insights

This case highlights that COVID-19 can cause coronary artery thrombosis, leading to ST-elevation myocardial infarction (STEMI). Management may differ from typical STEMI cases, emphasizing thrombus removal over stenting.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • COVID-19 is recognized as a prothrombotic state.
  • Myocardial damage and elevated troponin levels are observed in COVID-19 patients.
  • Acute coronary syndromes can occur in the context of SARS-CoV-2 infection.

Observation:

  • A 54-year-old male with COVID-19 presented with respiratory failure.
  • The patient developed a ST-elevation myocardial infarction (STEMI) during hospitalization.
  • Coronary angiography revealed a heavily thrombosed right coronary artery with no significant atherosclerotic disease.

Findings:

  • Successful revascularization of the thrombosed right coronary artery was achieved via thrombus retrieval and manual thrombectomy, without stenting.
  • Intracoronary thrombolysis was employed due to the heavy thrombus burden.
  • Post-procedure, the patient was managed with triple antithrombotic therapy, including an oral anticoagulant and dual antiplatelets.

Implications:

  • This case underscores the link between COVID-19 and coronary artery thrombosis.
  • Management of STEMI in COVID-19 patients may necessitate strategies focused on thrombus burden, differing from atherosclerotic causes.
  • Further research into COVID-19-associated thrombotic events and their specific therapeutic approaches is warranted.

Keywords:
COVID-19interventional cardiologyischaemic heart disease

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