Coronary thrombosis without underlying atherosclerotic plaque in patients with Omicron variant of coronavirus disease 2019: a case series
Abstract
Coronavirus disease 2019 (COVID-19) is associated with a hypercoagulable state that predisposes patients to thrombotic events, including acute myocardial infarction (AMI). In patients with COVID-19 presenting with ST-segment elevation myocardial infarction, coronary artery angiography often reveals significant thrombosis, which may occur in the presence or absence of underlying obstructive atherosclerotic plaques. We report a case series of three Chinese patients with the Omicron variant of COVID-19 infection who presented with acute myocardial infarction due to coronary thrombosis without underlying atherosclerotic plaque on coronary angiography. The first case involved a 33-year-old man with Covid-19 who had coronary thrombosis without underlying atherosclerotic plaque on coronary angiography. The second case was a 76-year-old man who developed infarct related ventricular septal defect and cardiogenic shock following acute myocardial infarction (AMI). The third case was a 76-year-old woman with AMI who was also found to have venous thromboembolism. All patients were discharged and continued to improve symptomatically on follow-up phone conversations. This case series highlights that infection with the Omicron variant of COVID-19 virus (especially its critical and severe type) can increase thrombogenicity and contribute to coronary thrombosis without underlying atherosclerotic plaque. Prompt diagnosis and appropriate treatment such as primary percutaneous coronary…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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