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Review
. 2020 Nov 24:15:e16.
doi: 10.15420/icr.2020.21. eCollection 2020 Apr.

Management of Acute Coronary Syndromes During the Coronavirus Disease 2019 Pandemic: Deviations from Guidelines and Pragmatic Considerations for Patients and Healthcare Workers

Henry Seligman  1   2 , Sayan Sen  1   2 , Sukhjinder Nijjer  1   2 , Rasha Al-Lamee  1   2 , Piers Clifford  1 , Amarjit Sethi  1 , Nearchos Hadjiloizou  1 , Raffi Kaprielian  1 , Punit Ramrakha  1 , Michael Bellamy  1 , Masood A Khan  1 , Jaspal Kooner  1   2 , Rodney A Foale  1 , Ghada Mikhail  1 , Christopher S Baker  1 , Jamil Mayet  1   2 , Iqbal Malik  1 , Ramzi Khamis  1   2 , Darrel Francis  1   2 , Ricardo Petraco  1   2
Affiliations
Review

Management of Acute Coronary Syndromes During the Coronavirus Disease 2019 Pandemic: Deviations from Guidelines and Pragmatic Considerations for Patients and Healthcare Workers

Henry Seligman et al. Interv Cardiol. .

Abstract

Coronavirus disease 2019 (COVID-19) is forcing cardiology departments to rapidly adapt existing clinical guidelines to a new reality and this is especially the case for acute coronary syndrome pathways. In this focused review, the authors discuss how COVID-19 is affecting acute cardiology care and propose pragmatic guideline modifications for the diagnosis and management of acute coronary syndrome patients, particularly around the appropriateness of invasive strategies as well as length of hospital stay. The authors also discuss the use of personal protective equipment for healthcare workers in cardiology. Based on shared global experiences and growing peer-reviewed literature, it is possible to put in place modified acute coronary syndrome treatment pathways to offer safe pragmatic decisions to patients and staff.

Keywords: COVID-19; acute coronary syndrome; angioplasty; safety; thrombolysis.

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Conflict of interest statement

Disclosure: HS has received research funding from Amgen. SS has received speaking fees from AstraZeneca, Pfizer and Philips Volcano, and an educational grant from Medtronic. SN has received speaking fees from Philips Volcano. RAL has received speaking fees from Philips Volcano. RP has acted as a consultant for Philips. All other authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Suggested Pathway for the Management of ST-elevation MI and High-risk Acute Coronary Syndrome Patients
Figure 2:
Figure 2:. Suggested Clinical Pathway for the Management of Non-STEMI and Acute Coronary Syndrome Patients
Figure 3:
Figure 3:. Suggested Use of Personal Protective Equipment by Cardiology Staff During the COVID-19 Pandemic
See this image and copyright information in PMC

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