key: cord-0849269-2oqsgyyd
authors: Rivero, Fernando; Antuña, Paula; Cuesta, Javier; Alfonso, Fernando
title: Severe coronary spasm in a COVID‐19 patient
date: 2020-08-01
journal: Catheter Cardiovasc Interv
DOI: 10.1002/ccd.29056
sha: c268c8b42c588fbbe348b97f844c7cfa1d1d5180
doc_id: 849269
cord_uid: 2oqsgyyd

Myocardial injury is frequently detected in coronavirus disease 2019 (COVID‐19) patients. However, up to one‐third of COVID‐19 patients showing ST‐segment elevation on the electrocardiogram have angiographically normal coronary arteries. We present a case of an acute coronary syndrome due to a coronary spasm in a severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) patient. This pathophysiological mechanism was clearly demonstrated by intracoronary imaging techniques (optical coherence tomography) and invasive vasospasm test.

Altogether, the intense inflammatory milieu of severe COVID-19 infection may provide a trigger able to elicit CV in some of these patients. A high degree of clinical suspicion is essential to be able to confirm the diagnosis of CV in patients with angiographically normal coronary arteries but also in those with associate stable coronary lesions.

Appropriate intense vasodilator treatment appears crucial to prevent CV in patients with severe COVID-19 disease presenting with episodes of dynamic ST-segment elevation.

Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China

ST-segment elevation in patients with Covid-19 -a case series

Genetic risk and geneenvironment interaction in coronary artery spasm in Japanese men and women

Myocardial localization of coronavirus in COVID-19 cardiogenic shock