Atypical ST-Segment-Elevation Myocardial Infarction Presentation in Patients With COVID-19 at a High-Volume Center in New York City

Miguel A.Alvarez Villela, Ahmad Alkhalil, Michael A. Weinreich, Jonathan Koslowsky, Shunsuke Aoi, M. Azeem Latib

Research output: Contribution to journalArticlepeer-review

Abstract

Atypical presentations of ST-segment-elevation myocardial infarction (STEMI) have been reported in patients who have COVID-19. We have seen this occurrence in our center in Bronx, New York, where multitudes of patients sought treatment for the coronavirus. We studied the prevalence of atypical STEMI findings among patients with COVID-19 who presented during the first 2 months of the pandemic. Consistent with previous reports, 4 of our 10 patients with COVID-19 and STEMI had no identifiable culprit coronary lesion; rather, they often had diffuse ST-segment elevations on surface electrocardiograms along with higher levels of D-dimer and inflammatory markers. In contrast, 32 of 33 patients without COVID-19 (97%) had a culprit lesion. The patients with COVID-19 and a culprit lesion more often needed thrombectomy catheterization and administration of glycoprotein IIb/IIIa inhibitors. Our study confirms that patients with COVID-19 often have atypical STEMI presentations, including the frequent absence of a culprit coronary lesion. Our findings can help clinicians prepare for these atypical clinical presentations.

Original languageEnglish (US)
Article numbere207446
JournalTexas Heart Institute Journal
Volume48
Issue number5
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • COVID-19
  • Cardiovascular dis-eases/physiopathology
  • Coronary angiography
  • Coronavirus infections/ diagnosis
  • Retrospective studies
  • ST elevation myocar-dial infarction/complica-tions/epidemiology
  • Time-to-treatment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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