55 / 64
CARDIOVASCULAR JOURNAL OF AFRICA • Volume 31, No 6, November/December 2020
AFRICA
335
Coronavirus disease 2019 (COVID-19) and simultaneous
acute anteroseptal and inferior ST-segment elevation
myocardial infarction
Mustafa Yolcu, Fusun Gunesdogdu, Metin Bektas, Derya Turan Bayirli, Kivanc Serefhanoglu
Abstract
Coronavirus disease 2019 (COVID-19) is a recently recog-
nised pandemic spreading rapidly from Wuhan, Hubei, to
other provinces in China and to many countries around the
world. The number of COVID-19-related deaths is steadily
increasing. Acute ST-segment elevation myocardial infarction
(STEMI) is a disease with high morbidity and mortality rates,
and primary percutaneous coronary intervention is usually
recommended for the treatment. A patient with diabetes
mellitus and hypertension for five years was admitted to the
emergency unit with symptoms of fever, cough and dyspnoea.
These symptoms were consistent with viral pneumonia and a
COVID PCR test was performed, which tested positive three
days later. The patient had chest pain on the eighth day of
hospitalisation. On electrocardiography, simultaneous acute
inferior and anterior STEMI were identified. High levels of
stress and increased metabolic demand in these patients may
lead to concomitant thrombosis of different coronary arter-
ies, presenting with two different STEMIs.
Keywords:
COVID-19, acute anterior wall myocardial infarction,
acute inferior wall myocardial infarction
Submitted 2/4/20, accepted 20/4/20
Published online 5/5/20
Cardiovasc J Afr
2020;
31
: 335–338
www.cvja.co.zaDOI: 10-5830-CVJA-2020-016
Coronavirus disease 2019 (COVID-19) is a recently recognised
pandemic spreading rapidly from Wuhan, Hubei, to other
provinces in China and to several countries throughout the
world.
1
The number of COVID-19-related deaths is steadily
increasing.
1
Acute ST-segment elevation myocardial infarction
(STEMI) is a disease with high morbidity and mortality rates,
and primary percutaneous coronary intervention (PPCI) is
usually recommended for the treatment.
2
Co-existence of
cardiovascular disease (CVD) is common in patients with
COVID-19 and is related to an increased mortality rate. In
this case report, we present a patient who was diagnosed with
simultaneous acute anteroseptal and inferior STEMI while he
was receiving treatment for COVID-19.
Case report
Our patient (a 55-year-old male, body mass index 26 kg/m
2
)
with diabetes mellitus (DM) and hypertension (HT) for five
years was admitted to the emergency unit on 25 March 2020
with symptoms of fever, cough and dyspnoea. He had a history
of stable angina pectoris and 2.5 years earlier had had a stent
implantation in his left anterior descending (LAD) artery. He
had no chest pain on admission.
He was pre-diagnosed with COVID-19 after a thorough
physical examinationandwork-up, including a thoracic computed
tomography (CT) scan. There was ground-glass opacity on the
CT scan. Azithromycin and oseltamivir treatment were started
for COVID-19. His COVID PCR test was positive on 28 March
and he was diagnosed with COVID-19. Hydroxychloroquine was
added to the treatment regime.
On the morning of 2 April, he experienced chest pain with
an increase in dyspnoea. As the level of oxygen saturation
decreased, he was intubated. On electrocardiography (ECG),
simultaneous acute inferior and anterior STEMI were identified
(Fig. 1). It was decided to proceed with the PPCI.
All necessary precautions were taken for viral protection. All
laboratory staff wore N95 masks and protective goggles with
single-use coveralls with an opening for the face. Additionally,
Department of Cardiology, Faculty of Medicine, Istanbul
Yeni Yuzyil University, Gaziosmanpasa Hospital,
Gaziosmanpasa, Istanbul, Turkey
Mustafa Yolcu, MD,
yolcudoctor@gmail.comDepartment of Family Medicine, Faculty of Medicine,
Istanbul Yeni Yuzyil University, Gaziosmanpasa Hospital,
Gaziosmanpasa, Istanbul, Turkey
Fusun Gunesdogdu, MD
Department of Anesthesiology, Faculty of Medicine,
Istanbul Yeni Yuzyil University, Gaziosmanpasa Hospital,
Gaziosmanpasa, Istanbul, Turkey
Metin Bektas, MD
Department of Infectious Diseases and Clinical
Microbiology, Faculty of Medicine, Istanbul Yeni Yuzyil
University, Gaziosmanpasa Hospital, Gaziosmanpasa,
Istanbul, Turkey
Derya Turan Bayirli, MD
Kivanc Serefhanoglu, MD
Case Report