TY - JOUR AU - Kumar, Barun AU - Kodliwadmath, Ashwin AU - Upadhyay, Amar AU - Singh, Anupam AU - N, Nanda PY - 2021/04/06 Y2 - 2024/03/28 TI - Apparently normal epicardial coronaries in a patient with inferior wall myocardial infarction on the background of mild coronavirus disease-2019: take a second look! JF - Monaldi Archives for Chest Disease JA - Monaldi Arch Chest Dis VL - 91 IS - 3 SE - Cardiology - Case Reports DO - 10.4081/monaldi.2021.1668 UR - https://www.monaldi-archives.org/macd/article/view/1668 SP - AB - <p>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.</p> ER -