Corona Virus Disease 2019 (COVID-19) Presenting as Acute ST Elevation Myocardial Infarction

Abstract

Patients with Covid-19 disease commonly present with symptoms related to respiratory illness, and less commonly they develop cardiovascular complications either on presentation or during the course of the disease. The mortality/morbidity is high in these patients with cardiovascular involvement. Acute ST-elevation myocardial infarction (STEMI) is a medical emergency which needs immediate coronary re-perfusion for better patient outcomes. Here we present a patient who presented to the emergency room with acute STEMI and later tested positive for COVID-19. She was successfully treated with coronary revascularization and stent placement, and remains on the ventilator to date as she quickly developed acute respiratory distress syndrome. We need more research in Covid-19 patients with cardiovascular involvement for early diagnosis, prevention of exposure to health care workers and effective treatment.

Keywords: acute respiratory distress syndrome; atypical covid; covid-19; stemi.

Figure 1. Electrocardiogram (EKG) showing ST elevation changes (Red arrow) in leads II, III and aVF. Reciprocal changes- ST depressions in leads V1, V2, V3 (Blue arrow)

Figure 2. Chest X-ray suggestive of bilateral pulmonary edema, more on the right compared to left (arrows pointing)

Figure 3. Electrocardiogram (EKG) showing resolution of ST elevation and reciprocal ST depression changes after the heart catheterization and stent placement

Figure 4. Chest X-ray showing bilateral ground glass opacities with worsening aeration suggestive of acute respiratory distress syndrome (ARDS) (arrows pointing)