Zaher Nathan, Sattar Yasar, Mahmood Syed, Vacek Tom, Alraies M Chadi
Internal Medicine, Detroit Medical Center/Wayne State University School of Medicine, Detroit, USA.
Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, USA.
Cureus. 2020 Sep 29;12(9):e10708. doi: 10.7759/cureus.10708.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause a hypercoagulable state that can complicate the management of patients presenting with acute myocardial infarction (MI). We present the case of a patient with coronavirus disease 2019 (COVID-19) with ST elevation MI who was treated with percutaneous coronary intervention and stenting to the left circumflex artery. He was treated appropriately with anticoagulation with appropriate activated clotting time. However, the coronary angiogram course was complicated with heavy thrombosis that involved the left circumflex artery and the left anterior descending artery. Physicians are urged to suspect heparin resistance in COVID-19 patients, particularly if those patients have venous thromboembolism or acute coronary syndrome while taking heparin.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）可导致高凝状态，这会使急性心肌梗死（MI）患者的治疗复杂化。我们报告一例2019冠状病毒病（COVID-19）合并ST段抬高型心肌梗死患者的病例，该患者接受了经皮冠状动脉介入治疗及左旋支动脉支架置入术。他接受了适当的抗凝治疗，活化凝血时间合适。然而，冠状动脉造影过程中出现了严重血栓形成，累及左旋支动脉和左前降支动脉。强烈建议医生怀疑COVID-19患者存在肝素抵抗，特别是当这些患者在使用肝素时发生静脉血栓栓塞或急性冠状动脉综合征。
