Treatment of a COVID-19 positive patient with acute myocardial infarction: a case report

    Authors

    Keywords

    acute myocardial infarction, nurse, COVID-19

    DOI

    https://doi.org/10.15836/ccar2021.368

    Full Text

    Introduction : Management of a patient with acute myocardial infarction (AMI) is complex and requires a good cooperation between physicians and nurses/technicians. At the time of the SARS-CoV-2 pandemic the care of such patients is even more complex. ( 1 ) The virus posed new challenges in the treatment and care of patients with AMI. Some people may feel the symptoms of heart disease but because of the risk of a pandemic they will not go to general practitioner or to the emergency department. Despite that, one should always keep in mind that early treatment saves lives. The aim of this paper was to show how at the time of the SARS-CoV-2 pandemic there is a complex care and treatment of patients with AMI, and how nursing interventions were carried out in such situations. Case report: 63-year-old patient was admitted to the Department of Intensive Cardiac Care with an AMI. Chest pain witch spreads to the left arm all the way to the elbow, that occurred after walking on a straight line of 100 metres was the reason that this patient came to the Emergency Department. The patient also states that he has a positive epidemiological history for COVID-19 infection. During the treatment in the Emergency Department, an electrocardiogram was performed, which showed myocardial infarction with ST-segment elevation. Along with the ECG, the patient’s blood was drawn, and a nasal swab for the SARS-CoV-2 virus was routinely taken. After the arrival of cardioselective enzymes the patient was prepared for urgent coronary angiography. At the Catheterization Lab coronary angiography and percutaneous coronary intervention was performed. Right coronary artery was occluded. After predilatation two drug eluting stents (Ultimaster 3.5/28 mm and Angiolite 4.0/16 mm) were placed in the right coronary artery. In the final coronary angiogram, there were no residual stenoses with TIMI III flow. The nurses and technicians were adequately prepared according to the instructions of the Croatian Institute of Public Health since the patient had a positive epidemiological history. After the coronary angiography patient was transferred to the Department of Intensive Care where all epidemiological measures were taken by the staff. After initial acute treatment the test for SARS-CoV-2 arrived positive. The patient was transported to University Hospital Dubrava which was a respiratory intensive care center.

    Cardiologia Croatica
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    Treatment of a COVID-19 positive patient with acute myocardial infarction: a case report

    Extended Abstract
    Issue11-12
    Published
    Pages368
    PDF via DOIhttps://doi.org/10.15836/ccar2021.368
    acute myocardial infarction
    nurse
    COVID-19

    Authors

    Valentina Gal*ORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Valentina PandžaUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Ivana PecakORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Nikolina ŠoštarićUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Tihana DabićORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Josipa PrskaloORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Marija VujčićORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia
    Ana VlašičekORCIDUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, Croatia

    Full Text

    Introduction : Management of a patient with acute myocardial infarction (AMI) is complex and requires a good cooperation between physicians and nurses/technicians. At the time of the SARS-CoV-2 pandemic the care of such patients is even more complex. ( 1 ) The virus posed new challenges in the treatment and care of patients with AMI. Some people may feel the symptoms of heart disease but because of the risk of a pandemic they will not go to general practitioner or to the emergency department. Despite that, one should always keep in mind that early treatment saves lives. The aim of this paper was to show how at the time of the SARS-CoV-2 pandemic there is a complex care and treatment of patients with AMI, and how nursing interventions were carried out in such situations. Case report: 63-year-old patient was admitted to the Department of Intensive Cardiac Care with an AMI. Chest pain witch spreads to the left arm all the way to the elbow, that occurred after walking on a straight line of 100 metres was the reason that this patient came to the Emergency Department. The patient also states that he has a positive epidemiological history for COVID-19 infection. During the treatment in the Emergency Department, an electrocardiogram was performed, which showed myocardial infarction with ST-segment elevation. Along with the ECG, the patient’s blood was drawn, and a nasal swab for the SARS-CoV-2 virus was routinely taken. After the arrival of cardioselective enzymes the patient was prepared for urgent coronary angiography. At the Catheterization Lab coronary angiography and percutaneous coronary intervention was performed. Right coronary artery was occluded. After predilatation two drug eluting stents (Ultimaster 3.5/28 mm and Angiolite 4.0/16 mm) were placed in the right coronary artery. In the final coronary angiogram, there were no residual stenoses with TIMI III flow. The nurses and technicians were adequately prepared according to the instructions of the Croatian Institute of Public Health since the patient had a positive epidemiological history. After the coronary angiography patient was transferred to the Department of Intensive Care where all epidemiological measures were taken by the staff. After initial acute treatment the test for SARS-CoV-2 arrived positive. The patient was transported to University Hospital Dubrava which was a respiratory intensive care center.