Apparently normal epicardial coronaries in a patient with inferior wall myocardial infraction on the background of mild coronavirus disease-2019: take a second look!

Monaldi Arch Chest Dis. 2021 Apr 6. doi: 10.4081/monaldi.2021.1668. Online ahead of print.ABSTRACTThe coronary angiographic (CAG) findings of ST elevation myocardial infarction (STEMI) in patients of coronavirus disease 2019 (COVID-19) range from increased coronary artery thrombus burden to normal coronaries due to STEMI mimics. Here we report the case of a 45-year-old gentleman who presented with evolved inferior wall myocardial infarction with ongoing angina along with mild COVID-19. CAG showed normal epicardial coronaries except for distal right posterior descending coronary artery (RPDA) 100% occlusion on careful examination. He was treated for the myocardial infarction with medical management along with treatment of COVID-19. The importance of our case is to highlight the possibility of distal total occlusion of small coronary branches which may be missed if not carefully looked for as a normal CAG in COVID-19 patient will require only supportive therapy, while the finding of distal 100% occlusion of RPDA deemed us to prescribe optimal medical therapy as per acute myocardial infarction protocol along with treatment for COVID-19.PMID:33840182 | DOI:10.4081/monaldi.2021.1668
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Authors: Source Type: research