TY - JOUR
T1 - STEMI associated with SARS-CoV-2 infection and the use of ECMO as a potential therapeutic approach in addition to the PCI
AU - Rahman, Tanvir
AU - Alayo, Quazim A.
AU - Chaudhary, Sibgha G.
AU - Moghadam, Reihaneh C.
AU - German, Matthew L.
AU - Ettinger, Neil A.
AU - Leidenfrost, Jeremy E.
AU - Cranston-D'Amato, Hope A.
AU - Rinder, Morton R.
AU - Donnelly, Julianne E.
N1 - Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - A 55-year-old male presented to the emergency department with the complaints of chest pain that started 4 h before presentation. Pain was located over the anterior chest, 5 out of 10 intensity, with radiation to the left arm. Chest x-ray on admission showed severe diffuse bilateral pulmonary infiltrates concerning for COVID-19 pneumonia. Electrocardiogram showed inferior and lateral ST-segment elevation compatible with acute inferolateral myocardial infarction. Successful percutaneous coronary intervention (PCI) of the proximal and mid-right coronary artery using the balloon angioplasty and drug-eluting stent was performed. Post-PCI stenosis was 0% with a thrombolysis in myocardial infarction (TIMI) flow of 3. Five-day course of azithromycin and hydroxychloroquine was completed with no improvement overall. Patient received two doses of 400 mg of tocilizumab intravenously on hospital days 5 (HD#5) and #6. The patient was proned, on FiO2 100%, PEEP 15 cm H2O, on epoprostenol sodium and paralytics and eventually received venovenous ECMO, which improved outcome.
AB - A 55-year-old male presented to the emergency department with the complaints of chest pain that started 4 h before presentation. Pain was located over the anterior chest, 5 out of 10 intensity, with radiation to the left arm. Chest x-ray on admission showed severe diffuse bilateral pulmonary infiltrates concerning for COVID-19 pneumonia. Electrocardiogram showed inferior and lateral ST-segment elevation compatible with acute inferolateral myocardial infarction. Successful percutaneous coronary intervention (PCI) of the proximal and mid-right coronary artery using the balloon angioplasty and drug-eluting stent was performed. Post-PCI stenosis was 0% with a thrombolysis in myocardial infarction (TIMI) flow of 3. Five-day course of azithromycin and hydroxychloroquine was completed with no improvement overall. Patient received two doses of 400 mg of tocilizumab intravenously on hospital days 5 (HD#5) and #6. The patient was proned, on FiO2 100%, PEEP 15 cm H2O, on epoprostenol sodium and paralytics and eventually received venovenous ECMO, which improved outcome.
KW - Acute coronary syndrome
KW - COVID-19 pneumonia
KW - Coronary artery thrombosis
KW - Cytokine storm
UR - http://www.scopus.com/inward/record.url?scp=85104832978&partnerID=8YFLogxK
U2 - 10.1093/omcr/omaa148
DO - 10.1093/omcr/omaa148
M3 - Article
C2 - 33732477
AN - SCOPUS:85104832978
SN - 2053-8855
VL - 2021
SP - 82
EP - 85
JO - Oxford Medical Case Reports
JF - Oxford Medical Case Reports
IS - 3
ER -