Key result
Intravenous streptokinase successfully revascularized a 72-year-old COVID-19-positive patient with an inferoposterior STEMI, leading to complete resolution of symptoms and ST segment elevation.
Why the study?
Different countries have varying consensus regarding the treatment of STEMI patients during the COVID-19 pandemic, where primary percutaneous coronary intervention is typically recommended.
Case Report (n=1)
No
Thrombolytics such as streptokinase may serve as a safe and effective alternative to primary PCI for low-risk, hemodynamically stable STEMI in COVID-19 positive patients when catheterization laboratory access is restricted.
Answers are grounded in this paper and cite their sources.
May support thrombolysis in select stable COVID-19 STEMI when PCI unavailable; hypothesis-generating and leaves open need for prospective validation.
Primary percutaneous coronary intervention is the recommended modality of treatment for acute ST-elevation myocardial infarction (STEMI). However, different countries now have different consensus about treatment of patients with STEMI during the COVID-19 pandemic. In this report, we describe a case of SARS-CoV-2-positive patient admitted with pneumonia. During hospital stay in COVID-19 designated special care, the patient developed inferoposterior wall myocardial infarction (MI) without haemodynamic instability and was treated successfully with thrombolytics (streptokinase) without any severe complications. To decrease the risk of in-hospital exposure to COVID-19 infection among the staff, in circumstances where there is no negative-pressure catheterisation laboratory and there is shortage in medical staff, thrombolytics can be used as a modality of treatment in low-risk, haemodynamically stable MI during this pandemic, as recommended by different cardiac societies. However, this needs further studies in order to reach local and international consensus.
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Rahman et al. (2021) conducted a case report in ST-elevation myocardial infarction (STEMI) in COVID-19 (n=1). Streptokinase was evaluated on Resolution of ST segment elevation and symptoms. Intravenous streptokinase successfully revascularized a 72-year-old COVID-19-positive patient with an inferoposterior STEMI, leading to complete resolution of symptoms and ST segment elevation.
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