Hassan Mubariz A, Batta Yashvardhan, Smith Tori, Afzal Muhammad Adil
Internal Medicine, Howard University Hospital, Washington, USA.
Internal Medicine, St. Joseph's Regional Medical Center, Paterson, USA.
Cureus. 2023 Jun 17;15(6):e40554. doi: 10.7759/cureus.40554. eCollection 2023 Jun.
We present a case report of a non-ST segment elevation myocardial infarction (NSTEMI) occurring in an 89-year-old male with severe rhabdomyolysis and COVID-19 infection. The patient had a complex medical history, including non-ischemic cardiomyopathy, sinus bradycardia status post permanent pacemaker placement, and multiple comorbidities. He presented to the emergency department after a mechanical fall and was found to be COVID-19 positive. Despite the absence of typical symptoms, the patient's elevated troponin levels and electrocardiogram findings indicated NSTEMI. The initial management included an acute coronary syndrome protocol and admission to the cardiac intensive care unit. During the hospitalization, the patient developed acute hypoxic respiratory failure and was treated for COVID-19 pneumonia. The patient's renal function and creatine kinase levels showed improvement, and cardiac catheterization revealed non-obstructive coronaries. The patient was discharged in stable condition with a follow-up scheduled.
我们报告一例89岁男性发生非ST段抬高型心肌梗死(NSTEMI)的病例,该患者同时患有严重横纹肌溶解症和新冠病毒感染。患者有复杂的病史,包括非缺血性心肌病、永久性起搏器植入术后的窦性心动过缓以及多种合并症。他在机械性跌倒后就诊于急诊科,被发现新冠病毒检测呈阳性。尽管没有典型症状,但患者肌钙蛋白水平升高及心电图表现提示为NSTEMI。初始治疗包括采用急性冠状动脉综合征治疗方案并收入心脏重症监护病房。住院期间,患者出现急性低氧性呼吸衰竭,并接受了新冠病毒肺炎治疗。患者的肾功能和肌酸激酶水平有所改善,心脏导管检查显示冠状动脉无阻塞。患者出院时病情稳定,并安排了随访。