open access

Vol 16, No 4 (2021)
Case report
Published online: 2021-05-26
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COVID-19 pandemic dilemmas: acute coronary syndrome, viral myocarditis or both?

Jan Wojciech Pęksa1, Marek Klocek1, Magdalena Polaczyk1, Marek Rajzer1
DOI: 10.5603/FC.a2021.0033
·
Folia Cardiologica 2021;16(4):263-268.
Affiliations
  1. Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St, 30-688 Kraków, Poland

open access

Vol 16, No 4 (2021)
Case Reports
Published online: 2021-05-26

Abstract

In December 2019, a new virus was identified – SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2), which quickly became the cause of a global pandemic. Due to the high infectivity of this virus, it was necessary to develop specific patterns of management for patients with acute cardiac problems dangerous to their health and life, associated with this pathogen. We present a middle-aged female infected with SARS-CoV-2, where acute coronary syndrome (ACS) was suspected due to reported chest pain, elevated cardiac markers and the presence of risk factors for ischemic heart disease. However, the coronary angiography did not show any atherosclerotic changes and, therefore, myocardial infarction with non-obstructive coronary arteries (MINOCA) was diagnosed. Myocarditis secondary to SARS-CoV-2 infection could be a possible cause of ACS during COVID-19 pandemic.

Abstract

In December 2019, a new virus was identified – SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2), which quickly became the cause of a global pandemic. Due to the high infectivity of this virus, it was necessary to develop specific patterns of management for patients with acute cardiac problems dangerous to their health and life, associated with this pathogen. We present a middle-aged female infected with SARS-CoV-2, where acute coronary syndrome (ACS) was suspected due to reported chest pain, elevated cardiac markers and the presence of risk factors for ischemic heart disease. However, the coronary angiography did not show any atherosclerotic changes and, therefore, myocardial infarction with non-obstructive coronary arteries (MINOCA) was diagnosed. Myocarditis secondary to SARS-CoV-2 infection could be a possible cause of ACS during COVID-19 pandemic.
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Keywords

COVID-19; acute coronary syndrome; myocarditis; MINOCA; case report

About this article
Title

COVID-19 pandemic dilemmas: acute coronary syndrome, viral myocarditis or both?

Journal

Folia Cardiologica

Issue

Vol 16, No 4 (2021)

Article type

Case report

Pages

263-268

Published online

2021-05-26

DOI

10.5603/FC.a2021.0033

Bibliographic record

Folia Cardiologica 2021;16(4):263-268.

Keywords

COVID-19
acute coronary syndrome
myocarditis
MINOCA
case report

Authors

Jan Wojciech Pęksa
Marek Klocek
Magdalena Polaczyk
Marek Rajzer

References (10)
  1. Ouassou H, Kharchoufa L, Bouhrim M, et al. The pathogenesis of coronavirus disease 2019 (COVID-19): evaluation and prevention. J Immunol Res. 2020; 2020: 1357983.
  2. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. 2020; 91(1): 157–160.
  3. Parohan M, Yaghoubi S, Seraji A, et al. Risk factors for mortality in patients with coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies. Aging Male. 2020; 23(5): 1416–1424.
  4. ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 Pandemic. https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance (February 7, 2021).
  5. Sawalha K, Abozenah M, Kadado AJ, et al. Systematic review of COVID-19 related myocarditis: insights on management and outcome. Cardiovasc Revasc Med. 2021; 23: 107–113.
  6. Sauer F, Dagrenat C, Couppie P, et al. Pericardial effusion in patients with COVID-19: case series. Eur Heart J Case Rep. 2020; 4(FI1): 1–7.
  7. Website of the Republic of Poland. Coronavirus: information and recommendations. https://www.gov.pl/web/coronavirus/temporary-limitations. (February 7, 2021).
  8. Thygesen K, Alpert JS, Jaffe AS, et al. Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). Glob Heart. 2018; 13(4): 305–338.
  9. Kammler J, Kypta A, Hofmann R, et al. TIMI 3 flow after primary angioplasty is an important predictor for outcome in patients with acute myocardial infarction. Clin Res Cardiol. 2009; 98(3): 165–170.
  10. Bikdeli B, Madhavan MV, Jimenez D, et al. Global COVID-19 Thrombosis Collaborative Group, Endorsed by the ISTH, NATF, ESVM, and the IUA, Supported by the ESC Working Group on Pulmonary Circulation and Right Ventricular Function. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC state-of-the-art review. J Am Coll Cardiol. 2020; 75(23): 2950–2973.

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