STEMI associated with SARS-CoV-2 infection and the use of ECMO as a potential therapeutic approach in addition to the PCI

Tanvir Rahman, Quazim A. Alayo, Sibgha G. Chaudhary, Reihaneh C. Moghadam, Matthew L. German, Neil A. Ettinger, Jeremy E. Leidenfrost, Hope A. Cranston-D'Amato, Morton R. Rinder, Julianne E. Donnelly

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)82-85
Number of pages4
JournalOxford Medical Case Reports
Volume2021
Issue number3
DOIs
StatePublished - Mar 1 2021

Keywords

  • Acute coronary syndrome
  • COVID-19 pneumonia
  • Coronary artery thrombosis
  • Cytokine storm

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