Left ventricular free wall rupture as a result of delayed presentation of an inferior ST-elevation myocardial infarction due to fear of COVID-19: case report.


Journal

Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113

Informations de publication

Date de publication:
22 Apr 2021
Historique:
received: 09 12 2020
accepted: 09 04 2021
entrez: 23 4 2021
pubmed: 24 4 2021
medline: 18 5 2021
Statut: epublish

Résumé

Left ventricular free wall rupture (LVFWR) is a rare complication after myocardial infarction and usually occurs 1 to 4 days after the infarct. Over the past decade, the overall incidence of LVFWR has decreased given the advancements in reperfusion therapies. However, during the COVID-19 pandemic, there has been a significant delay in hospital presentation of patients suffering myocardial infarctions, leading to a higher incidence of mechanical complications from myocardial infarctions such as LVFWR. We present a case in which a patient suffered a LVFWR as a mechanical complication from myocardial infarction due to delay in seeking care over fear of contracting COVID-19 from the medical setting. The patient had been having chest pain for a few days but refused to seek medical care due to fear of contracting COVID-19 from within the medical setting. He eventually suffered a cardiac arrest at home from a massive inferior myocardial infarction and found to be in cardiac tamponade from a left ventricular perforation. He was emergently taken to the operating room to attempt to repair the rupture but he ultimately expired on the operating table. The occurrence of LVFWR has been on a more significant rise over the course of the COVID-19 pandemic as patients delay seeking care over fear of contracting COVID-19 from within the medical setting. Clinicians should consider mechanical complications of MI when patients present as an out-of-hospital cardiac arrest, particularly during the COVID-19 pandemic, as delay in seeking care is often the exacerbating factor.

Sections du résumé

BACKGROUND BACKGROUND
Left ventricular free wall rupture (LVFWR) is a rare complication after myocardial infarction and usually occurs 1 to 4 days after the infarct. Over the past decade, the overall incidence of LVFWR has decreased given the advancements in reperfusion therapies. However, during the COVID-19 pandemic, there has been a significant delay in hospital presentation of patients suffering myocardial infarctions, leading to a higher incidence of mechanical complications from myocardial infarctions such as LVFWR.
CASE PRESENTATION METHODS
We present a case in which a patient suffered a LVFWR as a mechanical complication from myocardial infarction due to delay in seeking care over fear of contracting COVID-19 from the medical setting. The patient had been having chest pain for a few days but refused to seek medical care due to fear of contracting COVID-19 from within the medical setting. He eventually suffered a cardiac arrest at home from a massive inferior myocardial infarction and found to be in cardiac tamponade from a left ventricular perforation. He was emergently taken to the operating room to attempt to repair the rupture but he ultimately expired on the operating table.
CONCLUSIONS CONCLUSIONS
The occurrence of LVFWR has been on a more significant rise over the course of the COVID-19 pandemic as patients delay seeking care over fear of contracting COVID-19 from within the medical setting. Clinicians should consider mechanical complications of MI when patients present as an out-of-hospital cardiac arrest, particularly during the COVID-19 pandemic, as delay in seeking care is often the exacerbating factor.

Identifiants

pubmed: 33888133
doi: 10.1186/s13019-021-01495-x
pii: 10.1186/s13019-021-01495-x
pmc: PMC8061883
doi:

Types de publication

Case Reports Journal Article Video-Audio Media

Langues

eng

Sous-ensembles de citation

IM

Pagination

106

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Auteurs

George H Nasr (GH)

Department of Medicine, University of California, Irvine, USA. gnasr@hs.uci.edu.

Diana Glovaci (D)

Department of Medicine, Division of Cardiology, University of California, Irvine, USA.

Andrew Mikhail (A)

Department of Emergency Medicine, University of California, Irvine, USA.

Steven Sinfield (S)

Department of Medicine, University of California, Irvine, USA.

Kevin Chen (K)

Department of Medicine, Division of Cardiology, University of California, Irvine, USA.

Hardikkumar Patel (H)

Department of Medicine, Division of Cardiology, University of California, Irvine, USA.

Michael Johl (M)

Department of Medicine, Division of Cardiology, University of California, Irvine, USA.

Bharath Chakravarthy (B)

Department of Emergency Medicine, University of California, Irvine, USA.

Siddharth Singh (S)

Department of Anesthesia & Perioperative Care, University of California, Irvine, USA.

Fabio Sagebin (F)

Department of Surgery, Division of Cardiothoracic Surgery, University of California, Irvine, USA.

Ailin Barseghian El-Farra (AB)

Department of Medicine, Division of Cardiology, University of California, Irvine, USA.

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