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COVID-19 康复期使因冠状动脉斑块破裂导致的无症状心肌梗死显现出来。

COVID-19-convalescence phase unmasks a silent myocardial infarction due to coronary plaque rupture.

机构信息

Department of Cardiology, Charité-University Medicine Berlin, Campus Virchow Klinikum, Berlin, Germany.

Berlin Institute of Health (BIH) Berlin-Brandenburg Center for Regenerative Therapy (BCRT), Charité-University Medicine Berlin, Campus Virchow Klinikum, Berlin, Germany.

出版信息

ESC Heart Fail. 2021 Apr;8(2):971-973. doi: 10.1002/ehf2.13186. Epub 2021 Jan 6.

Abstract

Increased risk of cardiovascular complications during and post-COVID-19 infection is more and more recognized-including myocarditis, arrhythmias, and myocardial infarctions (MIs). The mechanisms leading to these complications are direct virus-induced injuries, as well as potential thrombotic and inflammatory-induced mechanisms. To the latter, inflammatory plaque instability and plaque rupture are discussed entities contributing to MI-induced post-COVID-19 complications. Our case report describes the first time, when a temporary impairment of LVEF in the COVID-19-convalescence phase unmasks a silent MI due to coronary plaque rupture by using invasive (OCT) and non-invasive (CMR) modalities. Myocardial infarction might be an important differential diagnosis to consider in deteriorating patients with COVID-19, especially if dyspnoea persists after acute infection.

摘要

越来越多的研究表明,COVID-19 感染期间和感染后发生心血管并发症的风险增加,包括心肌炎、心律失常和心肌梗死(MI)。导致这些并发症的机制包括直接病毒引起的损伤,以及潜在的血栓形成和炎症引起的机制。在后一种机制中,炎症斑块不稳定和斑块破裂被认为是导致 COVID-19 后 MI 相关并发症的因素。本病例报告首次描述了一例 COVID-19 恢复期 LVEF 短暂受损的患者,通过使用侵入性(OCT)和非侵入性(CMR)手段,发现由于冠状动脉斑块破裂导致隐匿性 MI。心肌梗死可能是 COVID-19 恶化患者需要考虑的一个重要鉴别诊断,特别是在急性感染后呼吸困难持续存在的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee41/8006695/44cb71293a88/EHF2-8-971-g001.jpg

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