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STEMI associated with SARS-CoV-2 infection and the use of ECMO as a potential therapeutic approach in addition to the PCI

A 55-year-old male presented to the emergency department with the complaints of chest pain that started 4 h before presentation. Pain was located over the anterior chest, 5 out of 10 intensity, with radiation to the left arm. Chest x-ray on admission showed severe diffuse bilateral pulmonary infiltr...

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Autores principales: Rahman, Tanvir, Alayo, Quazim A, Chaudhary, Sibgha G, Moghadam, Reihaneh C, German, Matthew L, Ettinger, Neil A, Leidenfrost, Jeremy E, Cranston-D'amato, Hope A, Rinder, Morton R, Donnelly, Julianne E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947272/
https://www.ncbi.nlm.nih.gov/pubmed/33732477
http://dx.doi.org/10.1093/omcr/omaa148
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author Rahman, Tanvir
Alayo, Quazim A
Chaudhary, Sibgha G
Moghadam, Reihaneh C
German, Matthew L
Ettinger, Neil A
Leidenfrost, Jeremy E
Cranston-D'amato, Hope A
Rinder, Morton R
Donnelly, Julianne E
author_facet Rahman, Tanvir
Alayo, Quazim A
Chaudhary, Sibgha G
Moghadam, Reihaneh C
German, Matthew L
Ettinger, Neil A
Leidenfrost, Jeremy E
Cranston-D'amato, Hope A
Rinder, Morton R
Donnelly, Julianne E
author_sort Rahman, Tanvir
collection PubMed
description A 55-year-old male presented to the emergency department with the complaints of chest pain that started 4 h before presentation. Pain was located over the anterior chest, 5 out of 10 intensity, with radiation to the left arm. Chest x-ray on admission showed severe diffuse bilateral pulmonary infiltrates concerning for COVID-19 pneumonia. Electrocardiogram showed inferior and lateral ST-segment elevation compatible with acute inferolateral myocardial infarction. Successful percutaneous coronary intervention (PCI) of the proximal and mid-right coronary artery using the balloon angioplasty and drug-eluting stent was performed. Post-PCI stenosis was 0% with a thrombolysis in myocardial infarction (TIMI) flow of 3. Five-day course of azithromycin and hydroxychloroquine was completed with no improvement overall. Patient received two doses of 400 mg of tocilizumab intravenously on hospital days 5 (HD#5) and #6. The patient was proned, on FiO(2) 100%, PEEP 15 cm H(2)O, on epoprostenol sodium and paralytics and eventually received venovenous ECMO, which improved outcome.
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spelling pubmed-79472722021-03-16 STEMI associated with SARS-CoV-2 infection and the use of ECMO as a potential therapeutic approach in addition to the PCI Rahman, Tanvir Alayo, Quazim A Chaudhary, Sibgha G Moghadam, Reihaneh C German, Matthew L Ettinger, Neil A Leidenfrost, Jeremy E Cranston-D'amato, Hope A Rinder, Morton R Donnelly, Julianne E Oxf Med Case Reports Case Report A 55-year-old male presented to the emergency department with the complaints of chest pain that started 4 h before presentation. Pain was located over the anterior chest, 5 out of 10 intensity, with radiation to the left arm. Chest x-ray on admission showed severe diffuse bilateral pulmonary infiltrates concerning for COVID-19 pneumonia. Electrocardiogram showed inferior and lateral ST-segment elevation compatible with acute inferolateral myocardial infarction. Successful percutaneous coronary intervention (PCI) of the proximal and mid-right coronary artery using the balloon angioplasty and drug-eluting stent was performed. Post-PCI stenosis was 0% with a thrombolysis in myocardial infarction (TIMI) flow of 3. Five-day course of azithromycin and hydroxychloroquine was completed with no improvement overall. Patient received two doses of 400 mg of tocilizumab intravenously on hospital days 5 (HD#5) and #6. The patient was proned, on FiO(2) 100%, PEEP 15 cm H(2)O, on epoprostenol sodium and paralytics and eventually received venovenous ECMO, which improved outcome. Oxford University Press 2021-03-08 /pmc/articles/PMC7947272/ /pubmed/33732477 http://dx.doi.org/10.1093/omcr/omaa148 Text en © The Author(s) 2021. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Rahman, Tanvir
Alayo, Quazim A
Chaudhary, Sibgha G
Moghadam, Reihaneh C
German, Matthew L
Ettinger, Neil A
Leidenfrost, Jeremy E
Cranston-D'amato, Hope A
Rinder, Morton R
Donnelly, Julianne E
STEMI associated with SARS-CoV-2 infection and the use of ECMO as a potential therapeutic approach in addition to the PCI
title STEMI associated with SARS-CoV-2 infection and the use of ECMO as a potential therapeutic approach in addition to the PCI
title_full STEMI associated with SARS-CoV-2 infection and the use of ECMO as a potential therapeutic approach in addition to the PCI
title_fullStr STEMI associated with SARS-CoV-2 infection and the use of ECMO as a potential therapeutic approach in addition to the PCI
title_full_unstemmed STEMI associated with SARS-CoV-2 infection and the use of ECMO as a potential therapeutic approach in addition to the PCI
title_short STEMI associated with SARS-CoV-2 infection and the use of ECMO as a potential therapeutic approach in addition to the PCI
title_sort stemi associated with sars-cov-2 infection and the use of ecmo as a potential therapeutic approach in addition to the pci
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947272/
https://www.ncbi.nlm.nih.gov/pubmed/33732477
http://dx.doi.org/10.1093/omcr/omaa148
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