There is growing evidence of cardiac complications due to corona virus disease 2019 (COVID 19). Our case is a case of a young patient with COVID-19 and symptomatic sinus pauses.
Papillary muscle rupture is one of the rare and potentially
life-threatening complication usually following acute myocardial
infarction (AMI). Acute papillary muscle rupture (PMR) results in severe
mitral regurgitation rapidly progressing to florid pulmonary edema and
cardiogenic shock. Without emergent surgical intervention, the mortality
is extremely high. The management of STEMI patients in COVID 19 pandemic
is difficult and challenging. We present an unusual case of 56 years old
male who presented with acute inferior wall myocardial infarction
(IWMI), underwent successful thrombolysis, developed reinfarction 5 days
later complicated by acute postero-medial papillary muscle rupture
(PPMR) leading to severe acute mitral regurgitation.
Left ventricular thrombus (LVT) is a known complication of acute myocardial infarction (AMI). Vitamin K antagonists such as Warfarin showed a reduction in associated mortality and morbidity and are indicated as anticoagulants of choice in current guidelines. Since their approval for clinical use, there has been a dramatic increase in off-label use of direct oral anti-coagulants (DOAC) for LVT. In this case series, the authors share their successful experience with DOAC in the treatment of LVT.
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