Cardiology - Case Reports
6 April 2021
Vol. 91 No. 3 (2021)
https://doi.org/10.4081/monaldi.2021.1668

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

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COVID-19, ST elevation myocardial infarction, coronary angiography, thrombosis
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Authors

Barun Kumar
Department of Cardiology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India.
Ashwin Kodliwadmath
ashrocks33@gmail.com
Department of Cardiology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India.
Amar Upadhyay
Department of Pediatrics, Doon Medical College, Dehradun, India.
Anupam Singh
Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India.
Nanda N
Department of Endocrinology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India.

The 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.

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How to Cite



“Apparently Normal Epicardial Coronaries in a Patient With Inferior Wall Myocardial Infarction on the Background of Mild Coronavirus Disease-2019: Take a Second Look!”. 2021. Monaldi Archives for Chest Disease 91 (3). https://doi.org/10.4081/monaldi.2021.1668.
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