CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 6, November/December 2022 AFRICA 329 Subacute dual stent thromboses in a COVID-19-positive patient Jacques Liebenberg, Thadathilankal-Jess John, Hoosain Khalfey, Ibrahim D’Andrea, Charles Kyriakakis Abstract The hypercoagulable state of COVID-19 is resulting in an increasing number of unexpected venous and arterial thromboses in patients. We report a case of subacute dual coronary stent thrombosis in the setting of COVID-19 and we provide a brief review of current management recommendations. Keywords: ST-elevation myocardial infarction, STEMI, COVID19, subacute stent thrombosis Submitted 28/10/21, accepted 8/1/22 Published online 24/3/22 Cardiovasc J Afr 2022; 33: 329–332 www.cvja.co.za DOI: 10.5830/CVJA-2022-003 Case report A 71-year-old gentleman with hypertension presented with ischaemic chest pain. He reported non-remitting chest pain reaching maximal intensity two hours before presentation. It was noted that he had been diagnosed with COVID-19 11 days earlier and was convalescing at home. An electrocardiogram (ECG) revealed a posterior ST-elevation myocardial infarction (STEMI) (Fig. 1). He was normotensive but had Killip-2 heart failure with bibasal crackles and SPO2 of 88% on room air. The patient was loaded with 300 mg aspirin, 600 mg clopidogrel, 80 mg atorvastatin and 40 mg intravenous furosemide. Division of Cardiology, Stellenbosch University, Cape Town, South Africa Jacques Liebenberg, MB ChB, MMed (Int Med), FCP (SA), liebjurg@gmail.com Thadathilankal-Jess John, MB ChB, Dip HIV Man (SA), MMed (Int Med), MRCP (UK), FCP (SA) Pulmonology Department, Life Vincent Pallotti, Cape Town, South Africa Hoosain Khalfey, MB ChB, FCP (SA), Cert Pulmonology (SA) Emergency Department, Life Vincent Pallotti, Cape Town, South Africa Ibrahim D’Andrea, MB ChB, FCEM (SA), MMed (Emergency Medicine) Cardiology Department, Life Vincent Pallotti, Cape Town, South Africa Charles Kyriakakis, MB ChB, MMed (Int Med), FCP (SA), Cert Cardio (SA) Case Report Fig. 1. Electrocardiogram at initial presentation.
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