A Case of COVID-19 with Acute Myocardial Infarction and Cardiogenic Shock

Abstract

A 60-year-old male patient with coronavirus disease-2019 showed new onset ST-segment elevation in V1-V2 leads on electrocardiogram and cardiac enzyme elevation in intensive care unit. He had a history of type 2 diabetes mellitus, hypertension, and dyslipidemia. He was receiving mechanical ventilation and veno-venous extracorporeal membrane oxygenation treatment for severe hypoxia. Two-D echocardiogram showed regional wall motion abnormalities. We performed primary percutaneous coronary intervention for acute myocardial infarction complicating cardiogenic shock under hemodynamic support. He expired on the 16th day of admission because of cardiogenic shock and multi-organ failure. Active surveillance and intensive treatment strategy are important for saving lives of COVID-19 patients with acute myocardial infarction.

Cardiogenic Shock Caused by SARS-CoV-2 in a Patient with Serial Negative Nucleic Acid Amplification Tests. Case Report

“…The microbiological confirmation of COVID-19 diagnosis was made by positivity of SARS-CoV-2 serology after excluding other microbiological causes of myocarditis and ileocolitis. It is remarkable that, contrary to our case, all previous reported patients with cardiac involvement had a positive respiratory NAAT and most of them had pneumonia [ 3 , 5 , 7 – 9 , 13 – 15 ]. Nevertheless, there is also evidence that many patients with compatible clinical picture of COVID-19 have negative nasopharyngeal NAAT [ 16 ].…”

“…Cardiac injury due to SARS-CoV-2 refers to blood levels of troponin I concentration above the upper reference limit and seems to be caused by a combination of direct viral myocardial interstitial damage and organ injury caused by the severe acute systemic inflammatory response triggered by the infection [ 5 – 7 ]. Arrhythmias and acute coronary syndrome may also occur in the context of hypoxemia, myocardial inflammation and thrombotic phenomena [ 8 , 9 ]. In different published studies, patients with myocardial involvement by COVID-19 usually had cardiovascular underlying conditions and showed worse prognosis, including increased risk of intensive care unit admission and mortality compared with those without cardiac injury.…”

Cardiovascular Manifestations of COVID-19

“…instability, hypercoagulable state, microvascular dysfunction, hemodynamic change, and hypoxemia caused by severe inflammation [50,51]. The majority of ACS cases caused by CO-VID-19 are type 2 which result from a mismatch between oxygen supply and demand [20].…”

A Case of ST‐Elevation Acute Myocardial Infarction in a Nonhospitalized Patient with SARS‐CoV‐2 Pneumonia: Treatment with Primary Percutaneous Coronary Intervention

“…For cases of ST‐elevation myocardial infarction (STEMI) that developed during hospitalization for COVID‐19, treatment with percutaneous coronary intervention (PCI) has been reported. 2 , 3 , 4 We report PCI treatment of a case of acute myocardial infarction that occurred out of a hospital in a patient with COVID‐19.…”