Post-infectious acute myocardial infarction following COVID-19 infection in a young patient

It is now widely known that COVID-19 can also cause various extrapulmonary manifestations. Possible mechanisms of cardiovascular damage include direct myocardial damage due to hypercoagulability caused by systemic inflammation, which may also lead to destabilisation of coronary plaques. We present a case of a 30-year-old young man following asymptomatic COVID-19 infection, who was admitted to the emergency room of the Grande Ospedale Metropolitano di Reggio Calabria, Italy, with typical chest pain. The patient had no cardiovascular disease, cardiovascular risk factors including no family history of cardiovascular disease. Urgent coronary angiography showed critical stenosis of the middle-proximal portion of the left anterior descending artery (80%) with ulcerated plaque appearance. Regardless of cardiovascular risk factors, our case report emphasises the need to determine COVID-19 status in all patients with acute myocardial infarction during this pandemic.Copyright © 2023, CKS.

Bedside Echocardiographic Evaluation of Right Heart in COVID-19 Patients

Introduction: The pathophysiological changes caused by SARSCoV2 infection affect the heart-lung interaction, with a higher incidence of pulmonary thromboembolism (PE). AIM: Identify echocardiographic typical features of pulmonary embolism and to identify a correlation between advanced clinical, radiological and biohumoral stages with the estimated lung pressures and resistances, and with dimension and function of the right ventricle. Method(s): Echocardiographic bedside evaluation of right ventricular dimensions and function, tricuspid and pulmonary artery flow velocimetry (AcT) has been obtained with a portable ultrasound machine on 31 patients of hospitalized patients in COVID ward in April 2020 and the data have been related to clinical and radiological features, ECG signs of right ventricular strain and biohumoral parameters of vascular and cardiac disease. Result(s): Patients with a more serious clinical and radiologic disease, had lower AcT values (p 0.031 - p 0.06) and higher level of D-dimer. No increase of PAP estimated values has been detected.This reminds the so-called 60/60 sign in acute PE. No correlation has been seen between right ventricular dimension and function, ECG signs of RV strain neither with highest level of biohumoral parameters of vascular and cardiac disease. Conclusion(s): Despite of several limitations, the study suggests the utility of bedside echocardiografic evaluation in Sars-Cov2 patients, as integration of prognostic evaluation, to suspect a PE, and to guide follow-up for early detection of signs of chronic pulmonary hypertension.