Silent Myocardial Infarction and Acute Multiorgan Failure in a COVID-19 Patient: A Case Report

Area of Science:

• Cardiology
• Infectious Diseases
• Geriatrics

Background:

• Silent myocardial infarction (SMI) is increasingly recognized in elderly individuals with cardiovascular risk factors.
• The prevalence of SMI in patients with COVID-19 remains largely unknown.
• COVID-19 is associated with cardiovascular complications, but silent presentations are not well-documented.

Observation:

• A 77-year-old male with COVID-19 pneumonia presented with diabetic ketoacidosis and multiorgan failure.
• The patient experienced a silent ST-segment elevation myocardial infarction (STEMI) without typical anginal symptoms.
• This represents the first reported case of SMI in a COVID-19 patient.

Findings:

• Cardiac catheterization revealed ostial right coronary artery stenosis.
• A drug-eluting stent was successfully placed following a specialized safety protocol.
• The patient was discharged in stable condition to an extended-care facility.

Implications:

• COVID-19 patients, particularly the elderly, require cardiac evaluation for acute myocardial infarction, even in the absence of symptoms.
• Prompt diagnosis and intervention for myocardial infarction in COVID-19 patients, using appropriate safety measures, can be life-saving.
• This case underscores the importance of considering silent myocardial infarction in the differential diagnosis of COVID-19 presentations.