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新冠肺炎患者出现ST段抬高:病例系列

ST-segment elevation in patients presenting with COVID-19: case series.

作者信息

Saririan Mehrdad, Armstrong Richard, George Jon C, Olechowski Bartosz, O'Connor Stephen, Byrd James Brian, Chapman Andrew R

机构信息

Division of Cardiology, Valleywise Health/Creighton University, Phoenix, AZ, USA.

Department of Cardiology, St James's Hospital Dublin, Republic of Ireland.

出版信息

Eur Heart J Case Rep. 2021 Feb 8;5(2):ytaa553. doi: 10.1093/ehjcr/ytaa553. eCollection 2021 Feb.

Abstract

BACKGROUND

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the now pandemic disease, coronavirus disease (COVID-19). A number of reports have emerged suggesting these patients may present with signs and symptoms consistent with ST-segment elevation myocardial infarction without coronary artery occlusion.

CASE SUMMARY

We report an international case series of patients with confirmed COVID-19 infection who presented with suspected ST-segment elevation myocardial infarction. Three patients with confirmed COVID-19 presented with electrocardiogram criteria for ST-segment elevation myocardial infarction. No patient had obstructive coronary disease at coronary angiography. Post-mortem histology in one case demonstrated myocardial ischaemia in the absence of coronary atherothrombosis or myocarditis.

DISCUSSION

Patients with COVID-19 may present with features consistent with ST-segment elevation myocardial infarction and patent coronary arteries. The prevalence and clinical outcomes of this condition require systematic investigation in consecutive unselected patients.

摘要

背景

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是导致目前大流行疾病冠状病毒病(COVID-19)的病原体。已有多项报告表明,这些患者可能出现与ST段抬高型心肌梗死一致的体征和症状,而无冠状动脉闭塞。

病例总结

我们报告了一组国际确诊COVID-19感染患者的病例系列,这些患者表现出疑似ST段抬高型心肌梗死。3例确诊COVID-19患者出现符合ST段抬高型心肌梗死的心电图标准。冠状动脉造影显示无一例患者存在阻塞性冠状动脉疾病。1例患者的尸检组织学显示存在心肌缺血,而无冠状动脉粥样血栓形成或心肌炎。

讨论

COVID-19患者可能表现出与ST段抬高型心肌梗死和冠状动脉通畅一致的特征。这种情况的患病率和临床结果需要在连续的未经选择的患者中进行系统研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/000b/7898565/c4fee2735578/ytaa553f1.jpg

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