Asymptomatic COVID-19 and ST-elevation myocardial infarction in young adults: lessons learned from two similar cases
Hamayak Sisakian1, Seda Martirosyan1, Seda Shekoyan1
1Clinic of General and Invasive Cardiology, University Hospital #1, Yerevan State Medical University, Koryun Street 2, Yerevan, 375025, Armenia.
Insights
Young patients with asymptomatic COVID-19 infection can experience severe ST-elevation myocardial infarction (STEMI) and acute heart failure. Early intervention is crucial for managing these critical cardiovascular events.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- COVID-19 has been associated with various cardiovascular complications.
- ST-elevation myocardial infarction (STEMI) is a serious cardiac event requiring prompt treatment.
Observation:
- Two young patients with asymptomatic COVID-19 developed STEMI, severe acute heart failure, and ventricular fibrillation.
- Both patients required cardiopulmonary resuscitation and mechanical ventilatory support.
Findings:
- Despite young age and lack of symptoms, COVID-19 infection was linked to severe STEMI and heart failure.
- Primary percutaneous coronary intervention and complex treatment were effective in managing these critical cases.
Implications:
- Asymptomatic COVID-19 infection poses significant risks for severe acute heart failure in STEMI patients.
- Clinicians must consider COVID-19 as a potential factor in young STEMI patients, even without respiratory symptoms.
Abstract:
We present two cases of acute myocardial infarction in young patients with asymptomatic COVID-19 infection and ST-elevation myocardial infarction (STEMI), complicated by severe acute heart failure and ventricular fibrillation, resulting cardiopulmonary resuscitation and mechanical ventilatory support. Urgent primary percutaneous coronary intervention with further complex treatment was effective in both cases with critical cardiovascular state and co-morbid COVID-19 infection. This report illustrates the challenges in clinical severity of STEMI with COVID-19 infection, despite of young age and absence of clinical symptoms and chronic co-morbidities. STEMI patients with even asymptomatic COVID-19 infection may be presented with significantly higher rates of severe acute heart failure.
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