@article{ajmcr2020879,
author={{Kariyanna, Pramod Theetha and Hossain, Naseem A. and Jayarangaiah, Apoorva and Hossain, Nimrah.A. and Francois, Jonathan Christopher and Marmur, Jonathan D. and Salifu, Moro O. and McFarlane, Samy. I.},
title={Pharmaco-invasive Therapy for STEMI in a Patient with COVID-19: A Case Report},
journal={American Journal of Medical Case Reports},
volume={8},
number={7},
pages={192--196},
year={2020},
url={http://pubs.sciepub.com/ajmcr/8/7/9},
issn={2374-216X},
abstract={Coronavirus disease 2019 (COVID-19) is a pandemic that started in the Wuhan province of China in December 2019. It is associated with increased morbidity and mortality mainly due to severe acute respiratory syndrome 2 (SARS-Cov-2). Cardiac manifestations related to COVID-19 include demand ischemia, fulminant myocarditis, myocardial infarction and arrhythmias. In this report, we present a case of ST-segment elevation myocardial infarction (STEMI) in a 68-year-old man with COVID-19 who initially presented with chest pain and shortness of breath.  Patient's STEMI was managed with pharmaco-invasive strategy with tissue plasminogen activator (t-PA). He then developed acute hypoxic respiratory failure that was managed in the intensive care unit (ICU), together with multi-organ failure from which the patient died 2 days after presentation. Although the pathophysiologic mechanisms of STEMI in COVID-19 patients has not been clearly established, we hypothesize that interrelated pathogenetic factors, that we highlight in this report, can play a role in the development of STEMI, including plaque rupture secondary to systemic inflammation, increased pro-coagulants, endothelial dysfunction, impaired fibrinolysis and impaired oxygen utilization leading to demand/ supply mismatch and myocardial ischemia.},
doi={10.12691/ajmcr-8-7-9}
publisher={Science and Education Publishing}
}