eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2020-05-22 8 9 262 267 10.12691/ajmcr-8-9-2 AJMCR2020892 article Mohammed Al-Sadawi 1 Amena Mohiuddin 1 Naseem Hossain 1 Shakil Shaikh 2 Alan Feit 2 Benjamin Ramalanjaona 2 Moro O. Salifu 2 Samy I. McFarlane smcfarlane@downstate.edu 2 Department of Medicine, SUNY Downstate health Sciences University, Brooklyn, NY Division of Cardiovascular Medicine, SUNY Downstate health Sciences University, Brooklyn, NY Cardiac manifestations of COVID-19 include myocarditis, demand ischemia, myocardial infarction and arrhythmias with prothrombotic state being a major underlying pathogenetic mechanism. In this report we present a case of a 57-year-old, otherwise healthy, woman who presented with chest pain and nausea and was found to have an inferior wall ST-elevation myocardial infarction (STEMI) in the setting of an active COVID-19 infection. Angiography revealed tortuous coronary arteries with a 100% right coronary artery occlusion with high thrombus burden and normal left coronary system. In light of the available literature regarding the pro-thrombotic effects of this novel corona virus, we continued full dose anticoagulation with Enoxaparin after the cardiac catheterization and transitioned to rivaroxaban and we also continued the patient on dual antiplatelet therapy prior to discharge. http://pubs.sciepub.com/ajmcr/8/9/2/ajmcr-8-9-2.pdf STEMI (ST-Elevation Myocardial Infarction) COVID-19 severe acute respiratory syndrome 2 (SARS-Cov-2) Percutaneous Coronary Intervention Fibrinolysis Thrombosis Anticoagulation