Cor Vasa 2023, 65(1):129-132 | DOI: 10.33678/cor.2022.074
Beware of the Unexpected: Acute Coronary Thrombosis Following the Mildly Symptomatic COVID-19 Infection and Two Different Therapeutic Options
- Department of Cardiology, Medical Faculty, Aksaray University, Aksaray, Turkey
COVID-19 infection was declared a pandemic in March 2020 and is responsible for high morbidity and mortality around the globe. Although the most common clinical presentation is respiratory, cardiac complications are common and create new challenges for healthcare. We discuss two mildly symptomatic outpatients with COVID-19 presenting with acute ST-elevation myocardial infarction (STEMI) and high coronary thrombus burden without atherosclerotic plaque. Our report describes two different therapeutic approaches that illustrate the challenges encountered in the management of disseminated coronary thrombosis in patients with STEMI and COVID-19. Clinicians should be aware of the high pro-coagulant state caused by COVID-19, even in mildly symptomatic outpatients, and aggressive pharmacological therapy may be an effective alternative treatment option to percutaneous coronary intervention.
Keywords: Acute coronary thrombosis, COVID-19, Therapeutic options
Received: May 23, 2022; Revised: June 20, 2022; Accepted: June 25, 2022; Published: March 1, 2023 Show citation
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References
- Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol 2020;5:831-840.
Go to original source...
Go to PubMed...
- Dominguez-Erquicia P, Dobarro D, Raposeiras-Roubín S, et al. Multivessel coronary thrombosis in a patient with COVID-19 pneumonia. Eur Heart J 2020;41:2132.
Go to original source...
Go to PubMed...
- Hanff TC, Mohareb AM, Giri J, et al. Thrombosis in COVID-19. Am J Hematol 2020;95:1578-1589.
Go to original source...
Go to PubMed...
- Fried JA, Ramasubbu K, Bhatt R, et al. The variety of cardiovascular presentations of COVID-19. Circulation 2020;141:1930-1936.
Go to original source...
Go to PubMed...
- Zhai Z, Li C, Chen Y, et al. Prevention and treatment of venous thromboembolism associated with coronavirus disease 2019 infection: a consensus statement before guidelines. Thromb Haemost 2020;120:937-948.
Go to original source...
Go to PubMed...
- Al-Ani F, Chehade S, Lazo-Langner A. Thrombosis risk associated with covid-19 infection. A scoping review. Thromb Res 2020;192:152-160.
Go to original source...
Go to PubMed...
- Lacour T, Semaan C, Genet T, Ivanes F. Insights for increased risk of failed fibrinolytic therapy and stent thrombosis associated with COVID-19 in ST-segment elevation myocardial infarction patients. Catheter Cardiovasc Interv 2021;97:E241-E243.
Go to original source...
Go to PubMed...
- Hatamnejad MR, Tafti FF, Abdi A, et al. Coronary Thrombosis in a Patient with COVID-19 Who Was on Anticoagulant Therapy. Int Cardiovasc Res J 2021;15(3).
- Zaldivar Zurita HJ, Leal Cavazos JE, Carrillo Fernandez CD, et al. Single-Vessel Massive Coronary Thrombosis in a Patient with COVID-19 In-fection: A Case Report. Am J Clin Cardiol 2021;2:1012.
Go to original source...
- Viana T, Bezerra MLBG, Melo RMV, et al. Acute Myocardial Infarction with Coronary Thrombosis in a Covid-19 Patient without Risk Factors for Cardiovascular Disease. Arq Bras Cardiol 2021;116:511-515. [Article in English, Portuguese]
Go to original source...
Go to PubMed...
- Zaldivar Zurita HJ, Leal Cavazos JE, Carrillo Fernandez CD, et al. Single-Vessel Massive Coronary Thrombosis in a Patient with COVID-19 Infection: A Case Report. Am J Clin Cardiol 2021;2:1012.
Go to original source...
- Espejo PP, Gonzales DAC, Jiménez MVM, Fernandez FJP. Acute thrombosis of the right coronary artery in a patient with COVID-19. Eur Heart J Case Rep 2020;4:1-3.
Go to original source...
Go to PubMed...
- McCartney PJ, Eteiba H, Maznyczka AM, et al. Effect of lowdose intracoronary alteplase during primary percutaneous coronary intervention on microvascular obstruction in patients with acute myocardial infarction: a randomized clinical trial. JAMA 2019;321:56-68.
Go to original source...
Go to PubMed...
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