Coronary artery aneurysm presenting as ST-elevation myocardial infarction in a man with coronavirus disease 2019: a
David O Alao1, Amani Alabdouli2, Ala Jalabi2
1Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. davidalao@uaeu.ac.ae.
Insights
Coronavirus disease (COVID-19) can worsen cardiovascular emergencies. This case highlights a myocardial infarction caused by coronary artery aneurysm thrombosis in a COVID-19 patient, potentially impacted by healthcare system changes.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Patients with cardiovascular risk factors experience poorer outcomes with coronavirus disease (COVID-19).
- The COVID-19 pandemic led to reduced emergency cardiovascular care due to patient fear of hospital transmission.
- Regional health services reorganized into COVID-19 and non-COVID-19 facilities, but their impact on outcomes remains unclear.
Observation:
- A 35-year-old Pakistani man presented with acute ST-elevation myocardial infarction.
- He had thrombosis of a right coronary artery aneurysm and concurrent COVID-19.
- Intervention included percutaneous coronary angiography and thrombus removal, followed by transfer to a COVID-19 hospital.
Findings:
- The patient's myocardial infarction was linked to a coronary artery aneurysm and COVID-19.
- Surgical intervention was considered due to the aneurysm's size.
- The patient missed a crucial cardiology follow-up appointment after discharge.
Implications:
- This case presents an atypical cause of myocardial infarction in a COVID-19 patient.
- Healthcare system restructuring during the pandemic may have negatively affected patient care.
- Further research is needed to evaluate the effectiveness of segregated healthcare facilities for cardiovascular emergencies during pandemics.
Background:
Patients with underlying cardiovascular risk factors have worse clinical outcomes when they have coronavirus disease. In addition, a reduced workload of cardiovascular emergencies has been reported during the coronavirus pandemic due to patients' reluctance to attend hospitals for fear of contracting the disease. Regional health service reorganization, separating hospitals into coronavirus and non-coronavirus can mitigate this effect. However, the effectiveness of this approach on outcomes and patient satisfaction is unknown.
Case Presentation:
A 35-year-old Pakistani man with acute ST myocardial infarction was found to have thrombosis of the right coronary artery aneurysm and concomitant coronavirus disease. He had percutaneous coronary angiography and thrombus removal, and was transferred to a coronavirus hospital for the management of the infection. Due to the large size of the aneurysm, he was considered for surgical intervention. Following discharge from the coronavirus hospital and a period of stay at the isolation center, he failed to keep his cardiology follow-up appointment.
Conclusion:
This case illustrates an unusual cause of myocardial infarction in a patient with coronavirus infection whose care may have been adversely affected by the healthcare system restructuring.
More Related Videos
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Coronary Artery Disease III: Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Acute Coronary Syndrome V: Nursing Management
01:30Coronary Artery Disease I: Introduction