Management of ST-Elevation Myocardial Infarction in the COVID-19 Era: The Role of Thrombosis and Anticoagulation Strategy

Mohammed Al-Sadawi¹, Amena Mohiuddin¹, Naseem Hossain¹, Shakil Shaikh², Alan Feit², Benjamin Ramalanjaona¹, Moro O. Salifu¹ and Samy I. McFarlane^1,

¹Department of Medicine, SUNY Downstate health Sciences University, Brooklyn, NY

²Division of Cardiovascular Medicine, SUNY Downstate health Sciences University, Brooklyn, NY

Cite this paper

Mohammed Al-Sadawi, Amena Mohiuddin, Naseem Hossain, Shakil Shaikh, Alan Feit, Benjamin Ramalanjaona, Moro O. Salifu and Samy I. McFarlane. Management of ST-Elevation Myocardial Infarction in the COVID-19 Era: The Role of Thrombosis and Anticoagulation Strategy. American Journal of Medical Case Reports. 2020; 8(9):262-267. doi: 10.12691/AJMCR-8-9-2

Abstract

Cardiac manifestations of COVID-19 include myocarditis, demand ischemia, myocardial infarction and arrhythmias with prothrombotic state being a major underlying pathogenetic mechanism. In this report we present a case of a 57-year-old, otherwise healthy, woman who presented with chest pain and nausea and was found to have an inferior wall ST-elevation myocardial infarction (STEMI) in the setting of an active COVID-19 infection. Angiography revealed tortuous coronary arteries with a 100% right coronary artery occlusion with high thrombus burden and normal left coronary system. In light of the available literature regarding the pro-thrombotic effects of this novel corona virus, we continued full dose anticoagulation with Enoxaparin after the cardiac catheterization and transitioned to rivaroxaban and we also continued the patient on dual antiplatelet therapy prior to discharge.

Keywords

STEMI (ST-Elevation Myocardial Infarction), COVID-19, severe acute respiratory syndrome 2 (SARS-Cov-2), Percutaneous Coronary Intervention, Fibrinolysis, Thrombosis, Anticoagulation

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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