Title : Acute myocardial infarction as a complication of acute myocarditis against the background of coronavirus infection COVID-19
Abstract:
A new coronavirus infection identified by the World Health Organization Committee as COVID-19 ("Coronavirus disease 2019") with the official name of the causative agent of infection – SARS-CoV-2. Some patients develop hypercoagulation syndrome with thrombosis and thromboembolism, and other organs and systems, including the myocardium, are also affected. Myocardial lesions are accompanied by the development of supraventricular and ventricular arrhythmias, transient and persistent heart blockages. The development of tachyarrhythmias and blockades is accompanied by an increase in hypercoagulation activity of the blood with the possibility of developing type 2 myocardial infarction. The report presents a clinical case of patient K, 58 years old, with complex cardiac arrhythmias and diagnosed myocardial infarction, resistant to drug therapy, without the possibility of endovascular treatment of myocardial infarction due to the small diameter of the infarct-related artery. My report on the successful diagnosis and treatment of this patient, who was diagnosed with acute type 2 myocardial infarction as a complication of acute myocarditis against the background of COVID-19 coronavirus infection using angiocoronarography and MRI of the heart. Mechanisms were identified, including factors of hypercoagulation activity, thrombosis of the posterolateral branch of the right coronary artery, toxic and viral myocardial damage according to magnetic resonance therapy. The revealed transient blockade of the 2nd degree, polytopic polymorphic, group periods, ventricular extrasystoles, paroxysmal form of atrial fibrillation, which are a manifestation of covid-myocarditis, served as the basis for the development of coronary artery thrombosis with the occurrence of type 2 infarction, confirmed by clinical, laboratory and instrumental research methods (selective coronary angiography, magnetic resonance therapy, Holter monitoring. The patient received comprehensive treatment with a positive effect. She was discharged from the hospital with positive dynamics and improvement in her condition without complications.
Audience Take Away
Explain how the audience will be able to use what they learn?
- If patients have complex cardiac arrhythmias after a coronavirus infection, it is necessary to perform an MRI of the heart with contrast to exclude the development of myocarditis.
- The use of radiofrequency ablation for the treatment of cardiac arrhythmias in such patients is possible only after the completion of the process of inflammation in the myocardium.
- Often, when diagnosing myocarditis after a coronavirus infection, and timely medical treatment of the inflammatory process in the myocardium and cardiac arrhythmia make it possible to completely cure life-threatening and complex cardiac arrhythmias without the need for radiofrequency ablation.
- Teachers can use our experience and research results to expand their research or teaching.
- Treatment of type 2 thrombotic infarction consists primarily in conducting active anticoagulant and disaggregation therapy with the control of the D-dimer and all coagulating and anticoagulation factors of the blood.
