Mehrdad Saririan1, Richard Armstrong2, Jon C George3, Bartosz Olechowski4, Stephen O'Connor2, James Brian Byrd5, Andrew R Chapman6. 1. Division of Cardiology, Valleywise Health/Creighton University, Phoenix, AZ, USA. 2. Department of Cardiology, St James's Hospital Dublin, Republic of Ireland. 3. Division of Interventional Cardiology, Einstein Medical Center, Philadelphia, PA, USA. 4. Dorset Heart Centre, Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust Bournemouth, UK. 5. Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI, USA. 6. BHF Centre for Cardiovascular Science, University of Edinburgh, Chancellors Building, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.
Abstract
BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the now pandemic disease, coronavirus disease (COVID-19). A number of reports have emerged suggesting these patients may present with signs and symptoms consistent with ST-segment elevation myocardial infarction without coronary artery occlusion. CASE SUMMARY: We report an international case series of patients with confirmed COVID-19 infection who presented with suspected ST-segment elevation myocardial infarction. Three patients with confirmed COVID-19 presented with electrocardiogram criteria for ST-segment elevation myocardial infarction. No patient had obstructive coronary disease at coronary angiography. Post-mortem histology in one case demonstrated myocardial ischaemia in the absence of coronary atherothrombosis or myocarditis. DISCUSSION: Patients with COVID-19 may present with features consistent with ST-segment elevation myocardial infarction and patent coronary arteries. The prevalence and clinical outcomes of this condition require systematic investigation in consecutive unselected patients.
BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the now pandemic disease, coronavirus disease (COVID-19). A number of reports have emerged suggesting these patients may present with signs and symptoms consistent with ST-segment elevation myocardial infarction without coronary artery occlusion. CASE SUMMARY: We report an international case series of patients with confirmed COVID-19 infection who presented with suspected ST-segment elevation myocardial infarction. Three patients with confirmed COVID-19 presented with electrocardiogram criteria for ST-segment elevation myocardial infarction. No patient had obstructive coronary disease at coronary angiography. Post-mortem histology in one case demonstrated myocardial ischaemia in the absence of coronary atherothrombosis or myocarditis. DISCUSSION: Patients with COVID-19 may present with features consistent with ST-segment elevation myocardial infarction and patent coronary arteries. The prevalence and clinical outcomes of this condition require systematic investigation in consecutive unselected patients.
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