The Clot Thickens: COVID-19-Related ST-Elevation Myocardial Infarction in the Setting of Recent Boosters

Abstract

The coronavirus disease of 2019 has an array of pathological effects that continue to be discovered. Vaccines against COVID-19 have quickly emerged as our main tool. However, the thrombotic risk of both the virus and the vaccine is yet to be established, let alone together. In this case report, we present a case involving a recently diagnosed COVID-19 patient who developed an ST-elevated myocardial infarction (STEMI) after receiving his booster shot. Our aim is to highlight the standard of treatment outcomes in COVID-19-associated clots, familiarize ourselves with the complexity of the clot burden in a COVID-19associated STEMI, and illustrate the potential role of the cumulative pro-thrombotic effects of a recent COVID-19 booster with a concomitant symptomatic COVID-19 infection.

Multifaceted Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on ST-Elevation Myocardial Infarction (STEMI): A Literature Review of Incidence, Treatment Modalities, and Outcomes

“…While the correlation between these infrequent events and vaccination remains uncertain, their manifestation post-vaccination in healthy individuals without other apparent causes could suggest a potential association [67]. Potential mechanisms contributing to MI post-vaccination encompass Kounis syndrome inducing MI through allergic vasospasm or stent occlusion infiltrated by eosinophils or mast cells; vaccine-induced thrombotic thrombocytopenia characterized by abnormal blood clot formation and low platelet levels; ACS following influenza vaccine administration due to shared excipients like polysorbate 80 with COVID-19 vaccines; demand-supply mismatch ischemia triggered by vaccination-related stress, especially in elderly individuals with comorbidities; and myocarditis that can rarely occur post-vaccination, potentially leading to MI [68][69][70]. It has been observed that MI following the administration of COVID-19 vaccination occurred most frequently in males with a mean age of 63.45 years [69].…”