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

Submitted: November 7, 2020
Accepted: March 4, 2021
Published: April 6, 2021
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Authors

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

Kumar, Barun, Ashwin Kodliwadmath, Amar Upadhyay, Anupam Singh, and Nanda N. 2021. “Apparently Normal Epicardial Coronaries in a Patient With Inferior Wall Myocardial Infarction on the Background of Mild Coronavirus Disease-2019: Take a Second Look!”. Monaldi Archives for Chest Disease 91 (3). https://doi.org/10.4081/monaldi.2021.1668.