Slide 1:55-YEAR-OLD HEALTHY MAN WITH 1 WEEK OF FEVER & COUGH. CXR: BILATERAL PERIPHERAL INFILTRATES.
Slide 2: EKG DONE TO EVALUATE TACHYCARDIA. WHATโS YOUR READ?
Slide 3: FINAL READ: ANTEROLATERAL STEMI
Slide 4: ADDITIONAL INFO: POC Troponin: 0.27 Hypoxia, tachypnea improved ON 2L NC. STILL NO CHEST PAIN. YOUR DIAGNOSIS? TYPE I STEMI? COVID-19 MYOCARDITIS? NEXT BEST STEP? STEMI ALERT & CATH LAB
Slide 5: SEQUELAE OF COVID-19 INFECTION: ARRYTHMIA MYOCARDITIS ACS VTE HEART FAILURE SHOCK ACUTE MI. PROGNOSIS: Higher troponin levels are predictive of CV complications. MECHANISM: Toxic non-ischemic myocardial necrosis, likely cytokine mediated OR True MI – systemic inflammatory syndromes make plaques vulnerable to rupture OR True supply-demand mismatch in setting of tachycardia and significant increase in cardiac output in the setting of coexisting coronary disease
Slide 6: Cath revealed: Acute LAD occlusion. Stent was subsequently placed!
References
- Driggin E et al. J Am Coll Cardiol.ย 2020 Mar 18. pii: S0735-1097(20)34637-4. PMID 32201335.
Tags: 12 Lead, cardiology, COVID, COVID-19, EKG, STEMI