Why the study?
Literature reflects increased intracoronary thrombus STEMI in high-risk patients with active SARS-CoV-2 infection, but this pathology in young patients not typically considered high-risk needs reporting.
COVID-19 can precipitate intracoronary thrombus STEMI even in young patients without traditional cardiovascular risk factors.
ICT may drive MI in COVID-19 via hypercoagulability; leaves open whether targeted anticoagulation improves outcomes.
Myocardial infarcts (MIs) can be especially devastating when their pathogenesis stems from a coronary artery occlusion by an intracoronary thrombus (ICT). ICTs are most frequently a result of an underlying atherosclerotic plaque rupture, however, can also be a result of emboli, vasospasm, hypercoagulable states, among other etiologies. Patients suffering from the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appear to be in both a hypercoagulable and proinflammatory state resulting in an increased risk of clot formation, endothelial damage, and plaque destabilization, thus increasing the ICT burden in infected patients.1 The literature does reflect an increase in ICT ST-segment elevation myocardial infarction (STEMI) in already high risk patients with an active SARS-CoV-2 infection. Our case discusses this observed pathology in a young 24 year old patient not typically considered among a high risk population for a ICT STEMI.
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Upadhyay et al. (2021) studied this question.
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