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2020 ; 20
(4
): 437-439
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Lessons of the month 3: ST-elevation myocardial infarction and left ventricular
thrombus formation: an arterial thrombotic complication of severe COVID-19
infection
#MMPMID32675154
Fenton M
; Siddavaram S
; Sugihara C
; Husain S
Clin Med (Lond)
2020[Jul]; 20
(4
): 437-439
PMID32675154
show ga
We describe a case of an 82-year-old man who developed an anterior ST-elevation
myocardial infarction (STEMI) and left ventricular thrombus while an inpatient
following a diagnosis of severe COVID-19 infection (SARS-CoV-2). His D-dimer was
significantly elevated at 12,525 ng/mL (normal range <243). He unfortunately died
despite management with thrombolysis, warfarin and non-invasive ventilation. This
case provides an example of a likely arterial thrombotic complication of severe
COVID-19 infection. Clinicians should be aware of this possibility in such
patients, with a severely prothrombotic state as a possible underlying aetiology.
Further research is required to establish any causative link, pathophysiological
mechanisms and whether modification to existing venous thromboembolism
prophylaxis strategies may also reduce arterial thrombotic complications of
severe COVID-19 infection.