Boudihi Abdelaziz, Derar Charmake, Mazouzi Mosaab, Ismaili Nabila, El Ouafi Noha
Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco.
Department of Cardiology, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco.
Ann Med Surg (Lond). 2022 Jan;73:103152. doi: 10.1016/j.amsu.2021.103152. Epub 2021 Dec 4.
COVID 19 infection is considered a potentially serious disease since it is responsible for important respiratory and cardiovascular complications with a high morbid-mortality.
We report the case of a 54-year-old diabetic patient with hypertension who was admitted for heart failure with a reduced LVEF of 23% triggered by a pulmonary embolism and an acute coronary syndrome in the context of COVID-19 infection.
Indeed, these complications may be secondary to a prothrombotic and hypercoagulable state as well as endothelial dysfunction caused by the vascular and systemic inflammation and cytokine storm induced by SARS-CoV-2. Although the clinical polymorphism of COVID 19 infection is recognized, the association of myocardial ischemia with pulmonary embolism is uncommon and of adverse prognosis. This justifies a rapid and adapted multidisciplinary management.
In the absence of contraindication, thromboprohylaxis should be initiated for all hospitalized patients with COVID-19 to minimize the risk of thromboembolic complications.
新冠病毒感染被认为是一种潜在的严重疾病，因为它会导致重要的呼吸和心血管并发症，且病死率较高。
我们报告一例54岁的糖尿病合并高血压患者，因新冠病毒感染引发肺栓塞和急性冠状动脉综合征，导致左心室射血分数（LVEF）降至23%，进而因心力衰竭入院。
事实上，这些并发症可能继发于血栓前状态和高凝状态，以及由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的血管和全身炎症及细胞因子风暴导致的内皮功能障碍。尽管新冠病毒感染的临床多态性已得到认可，但心肌缺血与肺栓塞的关联并不常见，且预后不良。这证明了快速且适当的多学科管理的合理性。
在无禁忌证的情况下，应对所有住院的新冠病毒感染患者启动血栓预防措施，以将血栓栓塞并发症的风险降至最低。
