COVID-19-Associated ST Elevated Myocardial Infarction with Atrial Fibrillation: A Case Report

Abstract

Coronavirus disease 2019 (COVID-19) displays various clinical manifestations, and mounting evidence suggests that COVID-19 has extrapulmonary and cardiovascular involvement. Although cardiac effects are less prevalent in COVID-19 than pulmonary manifestations, understanding potential cardiac issues with COVID-19 is critical for risk stratification and improving outcomes. We report a male patient aged 56 years who presented with sudden onset of chest pain and dyspnea. The patient has a history of both hypertension and stroke. He has never traveled abroad or had previous contact with a COVID-19-positive patient. Physical examination demonstrates tachypnoea, desaturation, increased JVP, bronchial breath sounds, and rhonchi on the right basal lung. Inflammatory markers, liver function, and CKMB levels were all elevated in the laboratories. . Infiltrates and cardiomegaly were observed on a chest X-ray. Sinus tachycardia, irregular rhythm, and ST elevation on lead V1-V5 were detected on the electrocardiogram. Our patient was diagnosed with COVID-19 critical degree with STEMI and atrial fibrillation. Increased inflammatory cytokines caused by COVID-19 and a history of cardiovascular disease may play a crucial role in cardiac injury. The patient did not undergo reperfusion therapy, considering the late arrival to the hospital, and was managed with anticoagulant therapy. The patient responded well to therapy. After 15 days of treatment in an isolation room and two weeks in a non-isolation room, the patient exhibited clinical improvement and could be treated as an outpatient case. Patients with preexisting cardiovascular conditions are more likely to contract COVID-19, which significantly impacts the disease's course, treatment, and prognosis.

Keywords

• covid-19
• st elevated myocardial infarction
• atrial fibrillation