Inferior Wall Myocardial Infarction in Severe COVID-19 Infection: A Case Report

Abstract

Patient: Male, 56-year-old Final Diagnosis: COVID-19 Symptoms: Hypoxemia • pneumonia Medication:— Clinical Procedure: — Specialty: Cardiology Objective: Unusual clinical course Background: The novel coronavirus disease (COVID-19) has been declared a pandemic. With the ever-increasing number of COVID-19 patients, it is imperative to explore the factors related to the disease to aid patient management until a definitive vaccine is ready, as the disease is not limited to the respiratory system alone. COVID-19 has been associated with various cardiovascular complications including acute myocardial injury, myocarditis, arrhythmias, and venous thromboembolism. The infection is severe in patients with pre-existing cardiovascular disease, and a systemic inflammatory response due to a cytokine storm in severe COVID-19 cases can lead to acute myocardial infarction. Case Report: We present the case of a 56-year-old man with cardiovascular risk factors including coronary artery disease, hypertension, ischemic cardiomyopathy, and hyperlipidemia, who had COVID-19-induced pneumonia complicated with acute respiratory distress syndrome. He subsequently developed myocardial infarction during his hospitalization at our facility. He had a significant contact history for COVID-19. He was managed with emergent cardiac revascularization after COVID-19 was confirmed by real-time reverse transcription-polymerase chain reaction testing from a nasopharyngeal swab as per hospital policy for admitted patients. Apart from dual antiplatelet therapy, tocilizumab therapy was initiated due to the high interleukin-6 levels. His hospitalization was complicated by hemodialysis and failed extubation and intubation, resulting in a tracheostomy. Upon improvement, he was discharged to a long-term facility with a plan for outpatient follow-up. Conclusions: In high-risk patients with COVID-19-induced pneumonia and cardiovascular risk factors, a severe systemic inflammatory response can lead to atherosclerotic plaque rupture, which can manifest as acute coronary syndrome.

Arritmias Cardíacas no Contexto da Pandemia da COVID-19: Uma Revisão Integrativa da Literatura / Cardiac Arrhythmias in the COVID-19 Pandemic Context: An Integrative Literature Review

“…As pneumonias, que são muito comuns nos casos da COVID-19, podem evoluir para a síndrome do desconforto respiratório agudo, desencadeando assim uma insuficiência respiratória (MORALES et al, 2020;SHEIKH et al, 2020 (KAZI et al, 2020;ZHU et al, 2020).…”

“…. 20214.4 TRATAMENTOS MAIS UTILIZADOS EM PACIENTES COM A COVID-19 E MANIFESTAÇÕES CARDÍACASAs mais diversas terapias têm sido aplicadas aos pacientes com agravamento de COVID-19, uma delas é a terapia com Tocilizumabe, um medicamento anti-inflamatório, indicado devido aos altos níveis de IL-6 que ocorrem em pacientes com patologias cardíacas e que estão infectados pelo novo coronavírus, este medicamente age reduzindo os níveis séricos da citocina, mitigando, assim, os efeitos da cascata inflamatória observada na doença(SHEIKH et al, 2020). Remdesivir, outro agente antiviral, que atua sobre a replicação viral, começou a ser utilizado no tratamento de pacientes com a COVID-19, após um estudo clínico em fase 3 mostrar melhora no estado geral dos pacientes.…”

Retinal Hemorrhage after SARS-CoV-2 Vaccination

“…All of the vaccines are at least partially effective against SARS-CoV-2 [ 2 , 3 , 5 , 6 , 7 ]. However, few reports on vaccine safety have appeared, although some serious vaccine-related side-effects, including immune thrombotic thrombocytopenia (VITT), cerebral venous sinus thrombosis (CVST), and cardiomyopathy (all of which are life-threatening) were reported after mass inoculation began [ 8 , 9 , 10 , 11 , 12 ]. Although the mechanisms by which these conditions develop remain unclear, VITT patients seem to have antibodies against platelet factor 4 (anti-PF4 Ab); these mimic the effect of heparin by binding to a similar site on PF4, which allows PF4 to cluster into immune complexes that trigger Fcγ receptor IIa-dependent platelet activation [ 13 ].…”

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.…”

“…Although the respiratory problems caused by this disease have drawn much attention, diverse cardiovascular symptoms, including acute coronary syndrome, myocarditis, pericarditis, and pericardial effusion, 1 have also been associated with COVID‐19. For cases of ST‐elevation myocardial infarction (STEMI) that developed during hospitalization for COVID‐19, treatment with percutaneous coronary intervention (PCI) has been reported 2‐4 . We report PCI treatment of a case of acute myocardial infarction that occurred out of a hospital in a patient with COVID‐19.…”