Publication Date

11-1-2021

Journal

The Texas Heart Institute Journal

DOI

10.14503/THIJ-20-7446

PMID

34913970

Publication Date(s)

November 2021

Language

English

PubMedCentral® Posted Date

12-15-2021

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

Cardiovascular diseases/physiopathology, coronary angiography, coronavirus infections/diagnosis, COVID-19, retrospective studies, ST elevation myocardial infarction/complications/epidemiology, time-to-treatment

Abstract

Atypical presentations of ST-segment-elevation myocardial infarction (STEMI) have been reported in patients who have COVID-19. We have seen this occurrence in our center in Bronx, New York, where multitudes of patients sought treatment for the coronavirus. We studied the prevalence of atypical STEMI findings among patients with COVID-19 who presented during the first 2 months of the pandemic.

Consistent with previous reports, 4 of our 10 patients with COVID-19 and STEMI had no identifiable culprit coronary lesion; rather, they often had diffuse ST-segment elevations on surface electrocardiograms along with higher levels of D-dimer and inflammatory markers. In contrast, 32 of 33 patients without COVID-19 (97%) had a culprit lesion. The patients with COVID-19 and a culprit lesion more often needed thrombectomy catheterization and administration of glycoprotein IIb/IIIa inhibitors.

Our study confirms that patients with COVID-19 often have atypical STEMI presentations, including the frequent absence of a culprit coronary lesion. Our findings can help clinicians prepare for these atypical clinical presentations.

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