Yamada Takeshi, Taniguchi Norimasa, Nakajima Shunsuke, Hata Tetsuya, Takahashi Akihiko
Cardiovascular Department, Sakurakai Takahashi Hospital, Hyogo, Japan.
Kobe Womens' University Graduate School, Kobe, Hyogo, Japan.
J Cardiol Cases. 2024 Mar 5;29(6):272-275. doi: 10.1016/j.jccase.2024.02.012. eCollection 2024 Jun.
Coronavirus disease 2019 (COVID-19) is associated with an increased risk of thromboembolic events. However, there are few reports on multiple thromboembolic events in young patients with COVID-19. Herein, we report a case of multiple visceral arterial embolisms secondary to acute myocardial infarction in a young patient with COVID-19. A 36-year-old male developed sudden chest pain after being diagnosed with COVID-19. Emergency coronary angiography revealed total occlusion of the right coronary artery, and the patient underwent a subsequent emergency percutaneous coronary intervention (PCI) which achieved successful recanalization. The patient was administered a loading dose and a subsequent maintenance dose of aspirin and prasugrel and a continuous intravenous infusion of unfractionated heparin at 10,000 units per day. Echocardiography detected a left ventricular apical thrombus 3 days after PCI; a loading dose of warfarin was administered and promptly reached the therapeutic range. However, the patient developed superior mesenteric artery embolism and renal infarction on the 12th day after PCI. COVID-19 was considered to play a role in the thromboembolic events observed in this patient. This case highlights the need for individualized antithrombotic regimens when managing patients with COVID-19 who develop acute myocardial infarction.
Reportedly, coronavirus disease 2019 (COVID-19) is associated with an increased risk of venous and arterial thromboembolic events. However, few reports have described multiple thromboembolic events in younger patients with COVID-19. This case report describes arterial thromboembolism secondary to acute myocardial infection (AMI) in a patient with COVID-19. It highlights the need for individualized antithrombotic regimens when managing patients with COVID-19 who develop AMI.
2019冠状病毒病（COVID-19）与血栓栓塞事件风险增加相关。然而，关于COVID-19年轻患者发生多发性血栓栓塞事件的报道较少。在此，我们报告1例COVID-19年轻患者继发于急性心肌梗死的多发性内脏动脉栓塞病例。一名36岁男性在被诊断为COVID-19后突发胸痛。急诊冠状动脉造影显示右冠状动脉完全闭塞，患者随后接受了急诊经皮冠状动脉介入治疗（PCI），成功实现再通。患者接受了阿司匹林和普拉格雷的负荷剂量及后续维持剂量，并持续静脉输注普通肝素，每日10000单位。PCI术后3天，超声心动图检测到左心室心尖部血栓形成；给予负荷剂量的华法林，其迅速达到治疗范围。然而，患者在PCI术后第12天发生了肠系膜上动脉栓塞和肾梗死。COVID-19被认为在该患者观察到的血栓栓塞事件中起作用。该病例强调了在管理发生急性心肌梗死的COVID-19患者时，需要采用个体化抗栓方案。
据报道，2019冠状病毒病（COVID-19）与静脉和动脉血栓栓塞事件风险增加相关。然而，很少有报道描述COVID-19年轻患者发生多发性血栓栓塞事件。本病例报告描述了1例COVID-19患者继发于急性心肌感染（AMI）的动脉血栓栓塞。它强调了在管理发生AMI的COVID-19患者时，需要采用个体化抗栓方案。
