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COVID-19 with acute myocardial infarction evaluated using multimodal imaging: A case report

Jingyao Wang1, Yachao Li1, Mengjie Lei1

  • 1Department of Cardiology, Langfang People's Hospital, Hebei Medical University, Langfang Core Laboratory of Precision Treatment of CAD, Langfang, China.

Medicine
|July 23, 2025
PubMed

Insights

Coronavirus disease 2019 (COVID-19) may trigger acute myocardial infarction by causing inflammation and hypercoagulability, destabilizing coronary plaques. Monitoring inflammatory markers is crucial for patients with COVID-19 and cardiovascular risks.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Biology

Background:

  • Cardiovascular complications, including acute myocardial infarction, persist as a concern despite the diminished global impact of coronavirus disease 2019 (COVID-19).
  • COVID-19 may destabilize pre-existing coronary plaques via systemic inflammation and hypercoagulability.

Purpose of the Study:

  • To investigate the potential role of COVID-19 in acute myocardial infarction development.
  • To offer insights into diagnostic and therapeutic strategies for patients experiencing cardiovascular events post-COVID-19.

Main Methods:

  • A case study of a 41-year-old woman with no prior cardiovascular risk factors presenting with chest pain 5 days after COVID-19 diagnosis.
  • Diagnostic procedures included electrocardiography, troponin I measurement, emergency coronary angiography, and optical coherence tomography.
  • Interventions involved thrombus aspiration, optical coherence tomography-guided angioplasty, and initiation of lipid-lowering and dual antiplatelet therapies.

Main Results:

  • Coronary angiography revealed acute anterior myocardial infarction due to 90% stenosis and thrombus in the left anterior descending artery.
  • Optical coherence tomography identified vulnerable, non-ruptured plaques with macrophages and cholesterol crystals.
  • Post-procedural imaging indicated residual plaque burden and myocardial injury, suggesting dual ischemic and inflammatory processes.

Conclusions:

  • COVID-19 may induce acute myocardial infarction by promoting atherosclerotic plaque destabilization through inflammation and hypercoagulability.
  • Monitoring inflammatory markers and considering anti-inflammatory treatments are essential for managing such patients.
Abstract

Keywords:
COVID-19acute myocardial infarctioncase reportmultimodal imagingvasculitis

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