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

doi:10.1093/omcr/omaa148

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 journal › Article › peer-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 language	English
Pages (from-to)	82-85
Number of pages	4
Journal	Oxford Medical Case Reports
Volume	2021
Issue number	3
DOIs	https://doi.org/10.1093/omcr/omaa148
State	Published - Mar 1 2021

Keywords

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

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10.1093/omcr/omaa148

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Rahman, T., Alayo, Q. A., Chaudhary, S. G., Moghadam, R. C., German, M. L., Ettinger, N. A., Leidenfrost, J. E., Cranston-D'Amato, H. A., Rinder, M. R., & Donnelly, J. E. (2021). STEMI associated with SARS-CoV-2 infection and the use of ECMO as a potential therapeutic approach in addition to the PCI. Oxford Medical Case Reports, 2021(3), 82-85. https://doi.org/10.1093/omcr/omaa148

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

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.",

keywords = "Acute coronary syndrome, COVID-19 pneumonia, Coronary artery thrombosis, Cytokine storm",

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

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doi = "10.1093/omcr/omaa148",

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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.

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

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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 -

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

Abstract

Keywords

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