Montaseri Mohammad, Golchin Vafa Reza, Attar Armin, Ali Hosseini Seyed, Kojuri Javad
Cardiology Ward Shiraz University of Medical Sciences Shiraz Iran.
Professor Kojuri Cardiology Clinic Shiraz Iran.
Clin Case Rep. 2022 May 18;10(5):e05872. doi: 10.1002/ccr3.5872. eCollection 2022 May.
The coronavirus disease 2019 (COVID-19) pandemic originated from Wuhan, China, in late 2019. In addition to the respiratory system, COVID-19 also affects other organ systems. The disease can lead to cardiovascular complications such as myocarditis, acute myocardial infarction, acute heart failure, and venous thromboembolism; patients with COVID-19 experience more thrombotic events than non-COVID-19 patients. A 50-year-old male cigarette smoker presented to the emergency department (ED) with typical chest pain. His electrocardiography (ECG) showed an anterior STEMI. He developed multiple episodes of ventricular fibrillation (VF) and received defibrillator shocks. His angiogram showed thrombotic severe in-stent restenosis (ISR) of the left anterior descending (LAD) artery stents. A 70-year-old diabetic hypertensive woman presented to the ED with dyspnea and chest pain. The patient had undergone angioplasty two times beforehand, and a fresh angiogram revealed severe thrombotic ISR of LAD stents and another far midpart lesion after the stents. She underwent successful percutaneous coronary intervention (PCI). A 54-year-old man presented to the ED with typical chest pain commencing an hour beforehand. He had undergone angioplasty about 10 years earlier. The patient received the Oxford/AstraZeneca COVID-19 vaccine 36 h before developing chest pain. The ECG revealed an infero-posterior STEMI, and the angiogram depicted thrombotic occluded ISR in the RCA. The patient underwent successful PCI. Patients with COVID-19 or even with COVID-19 vaccination experience stent thrombosis due to a hypercoagulable state. Hence, we need standard guidelines to prevent stent thrombosis.
2019年冠状病毒病（COVID-19）大流行于2019年末起源于中国武汉。除呼吸系统外，COVID-19还会影响其他器官系统。该疾病可导致心血管并发症，如心肌炎、急性心肌梗死、急性心力衰竭和静脉血栓栓塞；COVID-19患者比非COVID-19患者经历更多的血栓形成事件。一名50岁男性吸烟者因典型胸痛就诊于急诊科（ED）。他的心电图（ECG）显示前壁ST段抬高型心肌梗死（STEMI）。他发生了多次室颤（VF）并接受了除颤电击。他的血管造影显示左前降支（LAD）动脉支架有血栓形成的严重支架内再狭窄（ISR）。一名70岁的糖尿病高血压女性因呼吸困难和胸痛就诊于ED。该患者此前已接受过两次血管成形术，新的血管造影显示LAD支架有严重的血栓形成的ISR以及支架后另一处远段中部病变。她接受了成功的经皮冠状动脉介入治疗（PCI）。一名54岁男性因一小时前开始的典型胸痛就诊于ED。他大约在10年前接受过血管成形术。该患者在出现胸痛前36小时接种了牛津/阿斯利康COVID-19疫苗。ECG显示下后壁STEMI，血管造影显示右冠状动脉（RCA）有血栓闭塞性ISR。该患者接受了成功的PCI。COVID-19患者甚至接种COVID-19疫苗的患者由于高凝状态会发生支架血栓形成。因此，我们需要标准指南来预防支架血栓形成。
