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J Cardiol Cases . Multiple systemic thromboembolism secondary to acute myocardial infarction in a young patient with coronavirus disease 2019 pneum

tetano

Editor, Senior Moderator
J Cardiol Cases


. 2024 Mar 5;29(6):272-275.
doi: 10.1016/j.jccase.2024.02.012. eCollection 2024 Jun. Multiple systemic thromboembolism secondary to acute myocardial infarction in a young patient with coronavirus disease 2019 pneumonia: A case report

Takeshi Yamada[SUP] 1 [/SUP], Norimasa Taniguchi[SUP] 1 [/SUP], Shunsuke Nakajima[SUP] 1 [/SUP], Tetsuya Hata[SUP] 1 [/SUP], Akihiko Takahashi[SUP] 1 2 [/SUP]



Affiliations
Abstract

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.
Learning objective: 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.

Keywords: Acute myocardial infarction; COVID-19; Case report; Percutaneous coronary intervention; Systemic thromboembolism.

 
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