Coronavirus Disease 19 (COVID-19) Affects the Occurrence of Acute Heart Attacks: Case Report
Background. Global Pandemic of COVID-19 is a viral infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that primary target in respiratory system and spread rapidly around the world through droplets and direct contact. On the other side, COVID-19 affects to damage the myocardial causing acute heart attacks including Unstable Angina (UAP), Non-ST Elevation Myocardial Infraction (NSTEMI) or ST Elevation Myocardial Infarction (STEMI) and still represents a major cause of morbidity and mortality worldwide that affects about 15.5 million in the United States. The common risk factors of ACS are male sex, family history of early myocardial infarction (55 years old), hypertension, diabetes, hyperlipidemia, smoking, sedentary lifestyle, and obesity. However, in this case report the viral infection is the only main cause of ACS
Case Description. A male 65 years old came to ER complained shortness of breath with no comobid. The ECG showed sinus rhythm, right bundle branch block, lateral ischemia. The COVID-19 RT-PCR resulted was positive with elevation of cardiac enzymes.
Discussion. ACE2 mediated SARS-CoV-2 enters into the lung alveolar epithelial cell and host cell. ACE2 is also spread widely in human heart, and vessels. Infection of endothelial and pericytes could lead to microvascular and microvascular dysfunction. Cytokine storm, increasing interleukin (IL)-6, IL-7, IL-22, and CXCL10 may leading to atherosclerosis plaque instability or rupture and contributing to development of acute coronary events.
Conclusion. COVID-19 can lead to NSTEMI. Although cardiac biomarker was high, NSTEMI need further examination including coronary angiography.
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