A Review of ST-Elevation Myocardial Infarction in Patients with COVID-19

Nima Ghasemzadeh1, Nathan Kim2, Shy Amlani3

  • 1Georgia Heart Institute, Gainesville, GA 30501, USA.

Heart Failure Clinics
|March 2, 2023
PubMed

Insights

Coronavirus disease 2019 (COVID-19) increases risks for ST-elevation myocardial infarction (STEMI) patients. COVID-19 patients with STEMI face higher morbidity and mortality compared to those without the virus.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • The COVID-19 pandemic has significantly increased global morbidity and mortality.
  • Patients with COVID-19 are susceptible to various cardiovascular complications, including acute coronary syndromes, stress-induced cardiomyopathy, and myocarditis.

Purpose of the Study:

  • To review current knowledge on ST-elevation myocardial infarction (STEMI) in COVID-19 patients.
  • To discuss the pathophysiology, clinical presentation, and outcomes of STEMI in the context of COVID-19.
  • To analyze the pandemic's impact on STEMI care.

Main Methods:

  • Literature review of current knowledge.
  • Analysis of pathophysiology, clinical presentation, and outcomes.
  • Assessment of the effect of the COVID-19 pandemic on STEMI care.

Main Results:

  • Patients with COVID-19 who develop STEMI exhibit a higher risk of morbidity and mortality compared to age- and sex-matched STEMI patients without COVID-19.
  • COVID-19 is associated with increased cardiovascular complications relevant to STEMI.
  • The pandemic has influenced the overall management and care pathways for STEMI.

Conclusions:

  • COVID-19 presents a significant risk factor for adverse outcomes in STEMI patients.
  • Understanding the interplay between COVID-19 and STEMI is crucial for clinical management.
  • Further research is needed to optimize STEMI care during and after the pandemic.

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
46
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
13
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
31
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
19
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
19
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
17