Masarweh Omar M, Gonzalez-Morales Ubaldo, Tahir Sara, Tahir Sana, Hussain Sayed T
Internal Medicine, University of Central Florida, Orlando, USA.
Physiology, University of Florida, Gainseville, USA.
Cureus. 2024 Jul 18;16(7):e64869. doi: 10.7759/cureus.64869. eCollection 2024 Jul.
Since the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019, we have witnessed its multi-organ system involvement, not limiting itself to the lungs. We present a case of a patient with asymptomatic coronavirus disease 2019 (COVID-19) infection who developed ST-elevation myocardial infarction (STEMI) due to coronary artery vasospasm. The patient exhibited symptoms of acute coronary syndrome, elevated troponins, and electrocardiographic changes consistent with STEMI. He was found to have significant coronary vasospasm on angiography that responded well to nitroglycerin. This case highlights the potential cardiovascular complications of COVID-19 infection, even when asymptomatic, and the importance of considering vasospasm as a possible mechanism in patients presenting with acute coronary syndrome. We also elaborate on some potential pathophysiological mechanisms in which COVID-19 may lead to coronary vasospasm.
自2019年严重急性呼吸综合征冠状病毒2（SARS-CoV-2）出现以来，我们目睹了它对多器官系统的累及，而不仅限于肺部。我们报告一例2019冠状病毒病（COVID-19）无症状感染者，该患者因冠状动脉痉挛发展为ST段抬高型心肌梗死（STEMI）。患者表现出急性冠状动脉综合征的症状、肌钙蛋白升高以及与STEMI一致的心电图变化。血管造影显示他有严重的冠状动脉痉挛，对硝酸甘油反应良好。该病例突出了COVID-19感染即使无症状时也可能出现的心血管并发症，以及在表现为急性冠状动脉综合征的患者中考虑血管痉挛作为可能机制的重要性。我们还阐述了COVID-19可能导致冠状动脉痉挛的一些潜在病理生理机制。
