Our Dedicated Effort to Save a COVID-19 Confirmed Patient with Myocardial Infarction.

A 73-year-old COVID-19 confirmed female was brought to our tertiary cardiovascular center because of acute myocardial infarction (AMI). Since cardiac arrest occurred with ventricular fibrillation (Fig. 1), an urgent coronary angiogram (CAG) was planned. Before CAG, all cathlab team members wore personal protective equipment (Fig. 2, Supplemental Video 1). CAG showed critical stenoses at both proximal and distal portions of left circumflex coronary artery (LCX) (Fig. 3A, Supplemental Video 2). After a 2.5×15 mm balloon was pre-dilated, we implanted two drug-eluting stents (3.0×24 mm and 2.25×28 mm, Synergy™, Boston Scientific, Marlborough, MA) for each lesion (Fig. 3B, C, Supplemental Videos 3, 4). After the 2.5×12 mm non-compliant balloon was subsequently post-dilated due to stent under-expansion, the final CAG showed excellent stent apposition and expansion (Fig. 3D, Supplemental Video 5). Thereafter, the patient maintained the treatment of COVID-19 infection, including remdesivir and dexamethasone. After full recovery, she was successfully discharged from the hospital.

FIG. 1

During the hospitalization to the intensive care unit, ventricular fibrillation with sudden cardiac arrest occurred. After electrical defibrillation, the patient was successfully resuscitated.

FIG. 2

All cathlab team members wore personal protective equipments. (A, B) The cardiac cathlab nurse set up the procedure table then was ready for coronary angiography. (C) The patient was transported to the cardiac cathlab via a isolation chamber. (D) The primary operator started to puncture the femoral artery.

FIG. 3

(A-C) Since critical stenoses at both proximal and distal portions of LCX were noted, stenting was performed at each lesion. (D) Final angiogram showed good angiographic results.

Some cases about COVID-19 patients with AMI have been reported in the literature.123 This is the first case of a COVID-19 confirmed patient with AMI in our tertiary center. Despite the time-sensitive nature of AMI, a treatment delay between diagnosis and procedure may occur among COVID-19 patients. We should make efforts to reduce this in-hospital treatment delay.