scholarly journals Late-onset myocardial infarction and autoimmune haemolytic anaemia in a COVID-19 patient without respiratory symptoms, concomitant with a paradoxical increase in inflammatory markers: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Maria Chiara Pelle ◽  
◽  
Bruno Tassone ◽  
Marco Ricchio ◽  
Maria Mazzitelli ◽  
...  
Keyword(s):  
Haemolytic Anaemia ◽  
Inflammatory Markers ◽  
Myocardial Injury ◽  
Late Onset ◽  
Cardiovascular Complications ◽  
Autoimmune Haemolytic Anaemia ◽  
Case Presentation ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Short Time

Abstract Background In December 2019, a new coronavirus (named severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) spread from China, causing a pandemic in a very short time. The main clinical presentation of SARS-CoV-2 infection (COVID-19, coronavirus disease-2019) is pneumonia, but several cardiovascular complications may also occur (e.g., acute coronary syndromes, pulmonary embolism, stroke, arrhythmias, heart failure and cardiogenic shock). Direct or indirect mechanisms induced by SARS-CoV-2 could be implicated in the pathogenesis of these events. Case presentation We report herein the third case of COVID-19 autoimmune haemolytic anaemia (AIHA) reported so far, which occurredwithout any other possible explanations in a Caucasian patient. The patient also suffered from ST-elevation myocardial injury. Conclusions Both complications occurred quite late after COVID-19 diagnosis and were probably precipitated by systemic inflammation, as indicated by a significant delayed increase in inflammatory markers, including interleukin-6 (IL-6).

scholarly journals ST-Elevation Myocardial Infarction and COVID-19 Pneumonia: The Importance of Risk-Stratification of Myocardial Injury in COVID-19 Era

2021 ◽  
pp. 263246362199238
Author(s):  
Julio C. Sauza-Sosa ◽  
Oscar Millan-Iturbe ◽  
Jorge Mendoza-Ramirez ◽  
Carlos N. Velazquez-Gutierrez ◽  
Erika Lizeth De la Cruz Reyna ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Injury Risk ◽  
Myocardial Injury ◽  
Cardiovascular Complications ◽  
Adverse Outcomes ◽  
St Elevation ◽  
Diagnostic Coronary Angiography ◽  
Serial Measurements ◽  
Initial Classification

Background: Myocardial injury is a common manifestation in patients with coronavirus disease (COVID-19), and the correlation with adverse outcomes has been demonstrated; therefore, adequate monitoring of myocardial injury markers is very important. Case Summary: A patient with COVID-19 was hospitalized in our hospital with an initial classification of intermediate risk for myocardial injury, after serial measurements of myocardial injury markers, risk was readjusted to high, as shown later by electrocardiographic abnormalities. The patient underwent emergency diagnostic coronary angiography and successful angioplasty. The patient was discharged to home. Discussion: Myocardial injury risk-stratification is essential in patients with COVID-19, since it is essential in the recognition of patients who are susceptible to cardiovascular complications.

scholarly journals The Role of Mitochondrial Reactive Oxygen Species in Cardiovascular Injury and Protective Strategies

2016 ◽  
Vol 2016 ◽  
pp. 1-19 ◽  
Author(s):  
Danina M. Muntean ◽  
Adrian Sturza ◽  
Maria D. Dănilă ◽  
Claudia Borza ◽  
Oana M. Duicu ◽  
...  
Keyword(s):  
Reactive Oxygen Species ◽  
Myocardial Injury ◽  
Reactive Oxygen ◽  
Oxygen Species ◽  
Early Reperfusion ◽  
Coronary Syndromes ◽  
Ros Formation ◽  
St Elevation ◽  
Protective Strategies ◽  
Routine Therapy

Ischaemia/reperfusion (I/R) injury of the heart represents a major health burden mainly associated with acute coronary syndromes. While timely coronary reperfusion has become the established routine therapy in patients with ST-elevation myocardial infarction, the restoration of blood flow into the previously ischaemic area is always accompanied by myocardial injury. The central mechanism involved in this phenomenon is represented by the excessive generation of reactive oxygen species (ROS). Besides their harmful role when highly generated during early reperfusion, minimal ROS formation during ischaemia and/or at reperfusion is critical for the redox signaling of cardioprotection. In the past decades, mitochondria have emerged as the major source of ROS as well as a critical target for cardioprotective strategies at reperfusion. Mitochondria dysfunction associated with I/R myocardial injury is further described and ultimately analyzed with respect to its role as source of both deleterious and beneficial ROS. Furthermore, the contribution of ROS in the highly investigated field of conditioning strategies is analyzed. In the end, the vascular sources of mitochondria-derived ROS are briefly reviewed.

Neurologic, Psychiatric, and Cardiovascular Complications in Children Struck by Lightning

PEDIATRICS ◽  
1982 ◽  
Vol 70 (2) ◽  
pp. 190-192
Author(s):  
Suresh Kotagal ◽  
C. A. Rawlings ◽  
Su-chiung Chen ◽  
Garrett Burris ◽  
Soraya Nouri
Keyword(s):  
Myocardial Injury ◽  
Late Onset ◽  
Cardiovascular Complications ◽  
Pressure Monitoring ◽  
Inappropriate Secretion ◽  
Sensory Disturbances ◽  
Lightning Injury ◽  
Monitoring Devices ◽  
Recovery Of Consciousness

The neurologic changes following lightning injury include coma with cerebral edema, inappropriate secretion of antidiuretic hormone (ADH), seizures, cerebellar ataxia, and painful sensory disturbances. Deteriorating neurologic status may warrant the use of intracranial pressure monitoring devices. Myocardial injury and transient hypertension are generally evident at the onset. Monitoring of the cardiac rhythm may be needed for as long as a week for late onset arrythmia. Abnormalities of memory, mood, and affect noted on recovery of consciousness may persist for months, necessitating close psychiatric and neurologic follow-up.

scholarly journals Cardiovascular Complications of COVID-19 Infection

2021 ◽  
Vol 34 (9) ◽  
pp. 608
Author(s):  
Maria Ana Trêpa ◽  
António Hipólito Reis ◽  
Mario Oliveira
Keyword(s):  
Cardiac Arrhythmias ◽  
Myocardial Injury ◽  
Clinical Presentation ◽  
Cardiac Injury ◽  
Cardiovascular Complications ◽  
Adverse Outcomes ◽  
Cardiac Complications ◽  
Usual Practice ◽  
Coronary Syndromes ◽  
Worse Prognosis

Introduction: Reports of cardiovascular complications related to the COVID-19 infection have been frequent.Methods: Narrative review for relevant articles on the topic. The classic cardiovascular risk factors, like age, obesity, diabetes, and hypertension are associated with adverse outcomes in COVID-19 patients. Cardiovascular complications can have a diverse clinical presentation including silent myocardial injury, acute coronary syndromes, thromboembolism, cardiac arrhythmias, and heart failure. There are multiple mechanisms of cardiac injury that are not mutually exclusive. The approach to diagnosis and management should be carried out according to usual practice, while considering the particularities of COVID-19 infection.Conclusion: The interaction between SARS-CoV-2 and the heart is complex and is manifested in multiple ways. Regardless of the clinical presentation, cardiac complications convey a worse prognosis. Patients should be actively monitored and treated accordingly.

scholarly journals Therapeutic Implications of COVID-19 for the Interventional Cardiologist

2020 ◽  
pp. 107424842098273
Author(s):  
Matthew Kelham ◽  
Fizzah A. Choudry ◽  
Stephen Hamshere ◽  
Anne-Marie Beirne ◽  
Krishnaraj S. Rathod ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Evidence Base ◽  
Cardiovascular Complications ◽  
Review Of The Literature ◽  
Therapeutic Implications ◽  
Pulmonary Manifestations ◽  
Acute Myocardial Injury ◽  
Coronary Syndromes ◽  
Prognostic Importance ◽  
Cardiovascular Services

Although COVID-19 is viewed primarily as a respiratory disease, cardiovascular risk factors and disease are prevalent among infected patients and are associated with worse outcomes. In addition, among multiple extra-pulmonary manifestations, there has been an increasing recognition of specific cardiovascular complications of COVID-19. Despite this, in the initial stages of the pandemic there was evidence of a reduction in patients presenting to acute cardiovascular services. In this masterclass review, with the aid of 2 exemplar cases, we will focus on the important therapeutic implications of COVID-19 for interventional cardiologists. We summarize the existing evidence base regarding the varied cardiovascular presentations seen in COVID-19 positive patients and the prognostic importance and potential mechanisms of acute myocardial injury in this setting. Importantly, through the use of a systematic review of the literature, we focus our discussion on the observed higher rates of coronary thrombus burden in patients with COVID-19 and acute coronary syndromes.

Does chronic Chlamydia pneumoniae infection increase the risk of myocardial injury? Insights from patients with non-ST-elevation acute coronary syndromes

2002 ◽  
Vol 144 (6) ◽  
pp. 987-994 ◽  
Author(s):  
Brian Y.L. Wong ◽  
Judy Gnarpe ◽  
Koon K. Teo ◽  
E.Magnus Ohman ◽  
Connie Prosser ◽  
...  
Keyword(s):  
Acute Coronary Syndromes ◽  
Myocardial Injury ◽  
Chlamydia Pneumoniae ◽  
Coronary Syndromes ◽  
St Elevation

scholarly journals Relationship Between Myocardial Injury and Soluble P-Selectin in Non-ST Elevation Acute Coronary Syndromes

2005 ◽  
Vol 69 (5) ◽  
pp. 530-535 ◽  
Author(s):  
Mustafa Yazici ◽  
Sabri Demircan ◽  
Kenan Durna ◽  
Erdogan Yasar ◽  
Mahmut Sahin
Keyword(s):  
Acute Coronary Syndromes ◽  
Myocardial Injury ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Soluble P

scholarly journals Strong independent association between hospital bleeding and death in acute coronary syndromes: causal relationship or coexistence of two phenomena?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.H.V.M Melo ◽  
B Pontes ◽  
G.O.B Bagano ◽  
T.E.A.S Azevedo ◽  
P.H.C.F Filgueiras ◽  
...  
Keyword(s):  
Causal Relationship ◽  
Major Bleeding ◽  
Acute Coronary Syndromes ◽  
Myocardial Injury ◽  
Hospital Death ◽  
Natural Evolution ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Independent Association ◽  
Grace Score

Abstract Background Bleeding and hospital death have an independent association in observational records of acute coronary syndromes (ACS), leading to interpretation of this relationship as causal. However, association does not guarantee causality, and better exploitation of this phenomenon is necessary. Purpose To describe the association between bleeding and death of patients with ACS, exploring causality through the cascade of events that separate these two phenomena. Methods Patients consecutively admitted to Coronary Unit by objective criteria of ACS were included prospectively. Major bleeding during hospitalization was defined according to types 3 and 5 of the Universal Bleeding Classification. Logistic regression and sequence analysis of events were used to evaluate the association between bleeding and death. Results A total of 1104 patients were studied, age 65±14 years, 58% male, 23% with ST elevation. The incidence of major bleeding was 4.7% (52 cases). Bleeding patients presented mortality of 31% (16 deaths), compared to 4.7% death in the non-bleeding group (RR=6.6, 95% CI: 4.0–11). Those who bled had a GRACE score significantly higher than those free of bleeding (157±39 versus 121±38, P<0.001). After adjustment for this score, bleeding remained strongly associated with death (OR=4.5, 95% CI: 2.1–9.7, P<0.001). However, among the 16 deaths that occurred after bleeding, in 56% of the patients the death was due to hemorrhage, while the remainder was a consequence of the myocardial injury of the infarct or natural evolution of noncardiac morbidities. Conclusion The independent association between major bleeding and death in acute coronary syndromes is only partially mediated by causality. In the same proportion, deaths coexist with bleeding without a causal relationship. Funding Acknowledgement Type of funding source: None

Abstract 16860: Racial Disparity in COVID-19 Patients With Concomitant Myocardial Injury

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Brian C Case ◽  
Charan Yerasi ◽  
Brian Forrestal ◽  
Chava Chezar Azerrad ◽  
Lowell F Satler ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
African Americans ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Racial Disparity ◽  
Inflammatory Markers ◽  
Myocardial Injury ◽  
International Classification Of Diseases ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

Introduction: Cardiac involvement in Coronavirus Disease 2019 (COVID-19) is common. Estimated that 30% of patients hospitalized with COVID-19 have an elevated troponin and these patients have worse prognosis when compared to patients without myocardial injury. Hypothesis: The purpose of this study is to investigate if there is any racial disparity in the in-hospital clinical outcomes of COVID-19 patients with myocardial injury. Methods: This study included all COVID-19 positive patients within the MedStar Health System (11 acute hospitals in the DC/Maryland/Virginia area) with an elevation of troponin and a diagnosis of either ST-Elevation Myocardial Infarction (STEMI) or Non-ST-Elevation Myocardial Infarction (NSTEMI) based on International Classification of Diseases-10. Results: There was 3,589 COVID-19 admissions between March to June 2020. Of these, a total of 75 COVID-19 patients had either a STEMI or NSTEMI. Overall mean age was 70.9 ± 14.6 and 54.7% were male. Of these patients, the majority were African American (51; 68%) followed by Caucasians (15; 20%). The overall in-hospital mortality rate was 24.3%, with African Americans having a higher rate (73.7%) as compared to Caucasians (15.8%) p 0.05. Furthermore, African Americans trended toward having higher rates of intensive care unit (ICU) admissions, intubation, and longer ICU stays; however, not statistically significant. Despite African Americans appearing to be a sicker cohort, inflammatory markers and myocardial involvement did not differ between the two groups (Table 1). Conclusions: Patients with COVID-19 and concomitant myocardial injury have a high in-hospital mortality rate. There is a racial disparity with African Americans having a higher rate of in-hospital mortality. However, inflammatory markers and myocardial injury does not differ between the two groups meaning other unidentified underlying issue may be the etiology for a sicker cohort in African Americans.

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