MANIFESTATION OF COVID-19 IN THE FORM OF ACUTE MYOCARDIAL INFARCTION (case report)
PDF

Keywords

COVID-19, acute myocardial infarction, thrombosis, «cytokine storm».

Abstract

Acute myocardial infarction is necrosis of any myocardial mass due to ischemia. COVID-19 can be complicated by thrombosis and myocardial damage, which can lead to the deployment of a clinical picture similar to acute myocardial infarction. The material of this article is presented on the example of a clinical case. A woman aged 37 was diagnosed with an acute myocardial infarction, which later turned out to be a manifestation of a complicated course of coronavirus COVID-19 infection. This case drew attention to the absence of a clinical picture specific to this infection in the form of a damage to the respiratory system or intoxication. The case is also distinguished by the presence of a single uncharacteristic clinical manifestation of COVID-19 in the form of a cardiovascular event with elevations of the ST segment on the cardiogram and other objective data and additional research methods characteristic of acute myocardial infarction. The work also analyzed the pathogenetic mechanisms of acute myocardial infarction and cardiovascular complications of COVID-19, examined the general links of pathogenesis of these two pathological units and analyzed the causes of difficulties in their differential diagnosis. In this regard, there are unquestionably complications of differential diagnosis and the prescription of timely correct therapy. A deeper understanding of these data may improve the algorithms for diagnosing acute myocardial infarction and cardiovascular complications of COVID-19.

https://doi.org/10.35339/ic.7.4.180-183
PDF

References

Spuntarelli V, Luciani M, Bentivegna E, Marini V, Falangone F, Conforti G, Rachele ES, Martelletti P. (2020). COVID-19: is it just a lung disease? A case-based review. SN Compr Clin Med. 2020 Jul 28:1-6.

John B.Moore., Carl H.June (2020). Cytokine release syndrome in severe COVID-19. Science.-2020., Vol.368, Issue 6490, pp. 473-474

Li L, Zhou Q, Xu J (2020). Changes of Laboratory Cardiac Markers and Mechanisms of Cardiac Injury in Coronavirus Disease 2019. Biomed Res Int. 2020 May 26;2020:7413673.

Уніфікований клінічний протокол екстреної, первинної, вторинної (спеціалізованої) і третинної (високоспеціалізованої) медичної допомоги та медичної реабілітації "Гострий коронарний синдром з елевацією сегмента ST". Наказ МОЗ України № 455 (02.07.2014).

Kevin J. Clerkin, Justin A. Fried, Jayant Raikhelkar, Gabriel Sayer, Jan M. Griffin, Amirali Masoumi, … Nir Uriel (2020). COVID-19 and cardiovascular disease. Circulation 141, 1648–1655

Massimo Imazio, Karin Klingel, Ingrid Kindermann, Antonio Brucato, Francesco Giuseppe De Rosa, Yehuda Adler, Gaetano Maria De Ferrarri (2020). COVID-19 pandemic and troponin: indirect myocardial injury, myocardial inflammation or myocarditis. BMJ Journals, Volume 106, Issue 15

Yueying Wang, Zhaojia Wang, Gary Tse, Lin Zhang, Elaine Y Wan, Yutao Guo,… , Tong Liu (2020). Cardiac arrhythmias in patients with COVID-19. J Arrhythm. 2020 Jul 26;36(5):827-836.

Yuki Nakamura, Masaru Shimizu, Taeka Yamaki, Kohsuke Kushimoto, Ayahiro Yamashita, Kazuma Hayase,…, Bon Ohta (2020). Myocardial injury in a patient with severe coronavirus disease: A case report. J Infect Chemother. 2020 Oct 6:S1341-321X(20)30343-3.

Jose R.J., Manuel A. COVID-19 cytokine storm: the interplay between inflammation and coagulation. Lancet Respir Med. 2020;8:e46–e47. doi: 10.1016/S2213-2600(20)30216-2.

Chen C, Chen C, Yan J, Zhou N, Zhao JP, Wang DW (2020). Analysis of myocardial injury in patients with COVID‐19 and association between concomitant cardiovascular diseases and severity of COVID‐19. Zhong Hua Xin Xue Guan Bing Za Zhi. 2020;48:E008 10.3760/cma.j.cn112148-20200225-00123.

Matthew Z.T., Chek Meng Poh., Laurent Renia., Paul A.MacAry., Lisa F.P.Ng (2020). Tne trinity of COVID-19: immunity, inflammation and intervention. Nature Reviews Immunology.- 2020

Alí A, Boutjdir M, Aromolaran AS (2018). Cardiolipotoxicity, inflammation, and arrhythmias: role for interleukin‐6 molecular mechanisms. Front Physiol. 2018;9:1866.

Козлов ВК (2010). Цитокинотерапия: патогенетическая направленность при инфекционных заболеваниях и клиническая эффективность: Руководство для врачей. СанктПетербург: Альтер Эго; 2010. 148 с

Донцов, А. В. (2013). Эффективность даларгина в коррекции цитокинового профиля у больных ИБС и метаболическим синдромом. Курский научно-практический вестник «Человек и его здоровье», (1), 48-51.

Kishimoto T., Akira S., Taga T. IL-6 receptor and mechanism of signal transduction. International Journal of Immunopharmacology. 1992;14(3):431–438. doi: 10.1016/0192-0561(92)90173-I.

Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC (2020). COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nat Rev Cardiol. 2020 Sep;17(9):543-558. doi: 10.1038/s41569-020-0413-9.

Madjid, M., Safavi-Naeini, P., Solomon, S. D. & Vardeny, O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol. https://doi.org/10.1001/jamacardio.2020.1286 (2020).

Pavan K. Bhatraju, Bijan J. Ghassemieh, Michelle Nichols, Richard Kim, Keith R. Jerome, Arun K. Nalla,… T. Eoin West (2020). COVID-19 in critically ill patients in the Seattle region — case series. N. Engl. J. Med. 382, 2012–2022

Steven Siu-lung Li 1, Cheung-wah Cheng, Chiu-lai Fu, Yiu-han Chan, Man-po Lee, Johnny Wai-man Chan, Siu-fung Yiu (2003). Left ventricular performance in patients with severe acute respiratory syndrome: a 30-day echocardiographic follow-up study. Circulation 108, 1798–1803.

Rojulpote C, Gonuguntla K, Patil S, Bhattaru A, Bravo PE. (2020). COVID-19 and the Heart. Colomb Med (Cali). 2020 Jun 30;51(2):e4320.

Guido Tavazzi, Carlo Pellegrini, Marco Maurelli, Mirko Belliato, Fabio Sciutti , Andrea Bottazzi,… Eloisa Arbustin (2020). Myocardial localization of coronavirus in COVID-19 cardiogenic shock. Eur J Heart Fail 2020:1828.

ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation (2012). Eur Heart J. 2018;39:119–177. doi: 10.1093/eurheartj/ehx393

Sripal Bangalore, Atul Sharma, Alexander Slotwiner (2020). ST-Segment Elevation in Patients with Covid-19 — A Case Series. N Engl J Med 2020; 382:2478-2480

Yenerçağ M, Arslan U, Doğduş M, Günal Ö,… ,Şen A (2020). Evaluation of electrocardiographic ventricular repolarization variables in patients with newly diagnosed COVID-19.

Tan Z.C., Fu L.H., Wang D.D., Hong K. Cardiac manifestations of patients with COVID-19 pneumonia and related treatment recommendations. Zhonghua Xinxueguanbing Zazhi. 2020;48:E005. doi: 10.3760/cma.j.issn.cn112148-20200213-00077.

Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, Jain SS, Burkhoff D, Kumaraiah D, Rabbani L, Schwartz A, Uriel N (2020). Coronavirus disease 2019 (COVID‐19) and cardiovascular disease. Circulation 2020 Mar 21.

Masataka Nishiga, Dao Wen Wang, Yaling Han, David B. Lewis, Joseph C. (2020). COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nature Reviews Cardiology volume 17, p. 543–558

Giulio G. Stefanini, Matteo Montorfano, Daniela Trabattoni, Daniele Andreini, Giuseppe Ferrante, Marco Ancona,… ,Alaide Chieff (2020). ST-Elevation Myocardial Infarction in Patients With COVID-19. Circulation. 2020;141:2113–2116

Copyright for articles published in the journal is regulated by the License Agreement for the use of a scientific article in the journal, which is concluded between the author of the article (Licensor) and Kharkov National Medical University (Licensee, publisher of the journal "Inter Collegas"). The licensor grants to the Licensee a non-exclusive non-exclusive license for the use of the article (a license that does not exclude the use of the article by the Licensor and the issuance of licenses to others for use of this article) on the terms and for the period specified in the contract. The licensor (the author of the article) grants the Licensee the right to reproduce the article (publication in the journal "Inter Collegas", publication, duplication, duplication or other reproduction of the article without limiting the circulation of copies, each copy of the article must contain the name of the Licensor; Of general information, including the publication of the article in full or in part on the Internet on the journal page, the right to use the metadata of the article (titles, full names of authors, annotations, bibliography eskih materials) through the dissemination and communication to the public, processing and systematization, as well as inclusion in various databases and in-formational system).

The licensor grants the licensee the right to transfer, store and process his personal data (full name, scientific degree, academic title, place of work and position, contact information of the authors) with the purpose of including them in the database in accordance with the Law of Ukraine No. 2297 - VI "on protection of personal data" from 01.06.2010.

Personal data and metadata of the article are provided for their storage and processing in various databases and information systems, including them in analytical and statistical reporting, creating sound relationships between the objects of works of science, literature and art with personal data, etc. on unlimited territory. The licensee has the right to transfer the specified data for processing and storage to third parties provided that such a fact is notified with the provision of information about the third party (name and address) to the Licensor.