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
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
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.