PREHOSPITALNO DETEKTOVAN ACUTNI INFARKT MIOKARDA SA ST ELEVACIJOM KOD COVID 19 POZITIVNOG PACIJENTA
Keywords:
pandemic, COVID 19, STEMI, differential diagnosis, personal protection
Abstract
Objective And during the COVID 19 pandemic, patients may develop STEMI symptoms. We present a COVID 19 positive patient with prehospital STEMI, differential diagnostic concerns during hospitalization, and the implementation of a high-level safety strategy for healthcare professionals during care.Case report The EMS team transported the STEMI patient to the catheterization room. The patient was examined for anginal pain. Epidemiological surveys on COVID-19 negative. On examination: GCS 15, subfebrile, normotensive, normocardian, eupnoic, SaO2 98%. On ECG STEMI of lateral localization. Placed IV line, prescribed dual antiplatelet therapy. Rapid test is corona positive. Transported directly to the catheterization room. In addition to STEMI, other differential diagnostic diagnoses were considered. As definitive, the diagnosis of Angina pectoris was made. Healthcare workers used personal protective equipment at all levels.Conclusion Sometimes prehospital STEMI is not a definitive diagnosis. A strategy of a high level of safety of health workers is recommended.
References
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2. Bangalore S, Sharma A, Slotwiner A, Yatskar L, Harari R, Shah B, et al. ST-segment elevation in patients with Covid-19 - a case series. N Engl J Med 2020; DOI: 10.1056/NEJMc2009020. PMID: 32302081.
3. Nicole L, Writer S. Study: STEMI Often Not What It Appears in COVID-19 - Nonobstructive disease dominates but mortality is high, New York hospitals report. Medpage today. Infection disease: Covid 19. Available: https://www.medpagetoday.com/infectiousdisease/covid19/86031.
4. Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M. Et al. Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment–Elevation Myocardial Infarction Care in Hong Kong, China. Circ Cardiovasc Qual Outcomes. 2020; 13:e006631. DOI: 0.1161/CIRCOUTCOMES.120.006631.
5. 2020 ESC Guidance for the Diagnosis and Management of CV Disease in the Context of the COVID-19 Pandemic. Available: https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance.
6. Kovačević M, Srdanović I, Jung R. Šta nam novo donose preporuke za STEMI 2017?. Srce i krvni sudovi. 2017; 36(4): 225-228.
7. Mahmud E, Dauerman H, Welt FG, Messenger JC, Rao SV, Grines C, et al. Management of Acute Myocardial Infarction During the COVID-19 Pandemic. J Am Coll Cardiol. 2020; S0735-1097(20)35026-9. doi: 10.1016/j.jacc.2020.04.039. PMID: 32311816.
8. World Health Organization. Global surveillance for COVID-19 caused by human infection with COVID-19 virus: interim guidance, 20 March 2020. (2020; date last accessed). https://extranet.who.int/iris/restricted/handle/10665/331506
9. Center for Disease Control and Prevention. Coronavirus (COVID-19). https://www.cdc.gov/coronavirus/2019-nCoV/index.html.
10. European Centre for Disease Prevention and Control. ECDC technical report- Infection prevention and control for COVID-19 in healthcare settings - first update 12 March 2020 (March 12, 2020; date last accessed). https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-infection-prevention-and-control-healthcare-settings-march-2020.pdf.
11. Cheng X. Protecting cardiologists during the COVID-19 epidemic – lessons from Wuhan, China. (March 26, 2020; date last accessed). https://www.escardio.org/Education/COVID-19-and-Cardiology/protecting-cardiologists-during-the-covid-19-epidemic-lessons-from-wuhan.
12. Stručno-metodološko uputstvo za kontrolu unošenja i sprečavanje širenja novog korona virusa SARS-CoV-2 u Republici Srbiji. Beograd: Institut za javno zdravlje „Dr Мilan Јovanović Batut”, 2020.
13. Cepheid Receives Emergency Use Authorization from FDA for Rapid SARS-CoV-2 Test [news release]. Cepheid’s website. http://cepheid.mediaroom.com/2020-03-21-Cepheid-Receives-Emergency-Use-Authorization-from-FDA-for-Rapid-SARS-CoV-2-Test. Accessed March 21, 2020.
14. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting With ST-Segment Elevation: The Task Force for the Management of Acute Myocardial Infarction in Patients Presenting With ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J 2017. DOI: 10.1093/eurheartj/ehx393. PMID: 28886621.
15. Emiš-Vandlik A, Anđelić S, čolaković G, Bogunović S. Infarkt miokarda bez opstrukcije koronarnih arterija (MINOCA). Naučni časopis urgentne medicine HALO 194. 2019; 25(3): 165-172. doi: 10.5937/Halo1903165E.
16. Emiš-Vandlik N, Stefanović I, Anđelić S, Bogunović S, Nikolić T. Plućna embolija. Naučni časopis urgentne medicine HALO 194, 2013; 19(2): 65-77.
Published
2020/08/28
Section
Case report
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