COVID-19-convalescence phase unmasks a silent myocardial infarction due to coronary plaque rupture

ESC Heart Fail. 2021 Apr;8(2):971-973. doi: 10.1002/ehf2.13186. Epub 2021 Jan 6.

Abstract

Increased risk of cardiovascular complications during and post-COVID-19 infection is more and more recognized-including myocarditis, arrhythmias, and myocardial infarctions (MIs). The mechanisms leading to these complications are direct virus-induced injuries, as well as potential thrombotic and inflammatory-induced mechanisms. To the latter, inflammatory plaque instability and plaque rupture are discussed entities contributing to MI-induced post-COVID-19 complications. Our case report describes the first time, when a temporary impairment of LVEF in the COVID-19-convalescence phase unmasks a silent MI due to coronary plaque rupture by using invasive (OCT) and non-invasive (CMR) modalities. Myocardial infarction might be an important differential diagnosis to consider in deteriorating patients with COVID-19, especially if dyspnoea persists after acute infection.

Keywords: CMR; COVID-19; OCT; SARS-CoV-2; convalescence; heart; magnetic resonance; myocardial infarction; myocarditis; recovery; thrombosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • COVID-19 / complications*
  • Convalescence*
  • Humans
  • Male
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / etiology*
  • Myocardial Infarction / therapy
  • Plaque, Atherosclerotic / diagnosis*
  • Plaque, Atherosclerotic / etiology*
  • Plaque, Atherosclerotic / therapy
  • Stroke Volume