Infarto de miocardio en pacientes con COVID-19: Una complicación a tener en cuenta

Autores/as

Resumen

La COVID-19 se ha asociado con diversas complicaciones cardiovasculares, que incluyen lesión miocárdica aguda, miocarditis, arritmias y tromboembolismo venoso. La infección puede grave en pacientes con enfermedad cardiovascular preexistente y una respuesta inflamatoria sistémica debida a una tormenta de citosinas, en casos graves de esta enfermedad, puede provocar infarto agudo de miocardio (IAM). El pronóstico y la evolución clínica de los pacientes con COVID-19, que presentan esta complicación vascular, pueden ser deletéreos; por lo que se debe determinar su magnitud e identificar los casos de riesgo. En este artículo se presentan dos pacientes que presentaron IAM con elevación del segmento ST: un varón de 27 años de edad sin factores de riesgo coronario y otro de 63, con antecedentes de hipertensión arterial y hábito de fumar, ambos enfermaron de COVID-19 e ingresaron con síntomas respiratorios.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

1. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736-88. DOI: https://doi.org/10.1016/s0140-6736(18)32203-7

2. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal Definition of Myocardial Infarction (2018). J Am Coll Cardiol. 2018;72(18):2231-64. DOI: https://doi.org/10.1016/j.jacc.2018.08.1038

3. Libby P, Loscalzo J, Ridker PM, Farkouh ME, Hsue PY, Fuster V, et al. Inflammation, Immunity, and Infection in Atherothrombosis: JACC Review Topic of the Week. J Am Coll Cardiol. 2018;72(17):2071-81. DOI: https://doi.org/10.1016/j.jacc.2018.08.1043

4. Mogensen TH. Pathogen recognition and inflammatory signaling in innate immune defenses. Clin Microbiol Rev. 2009;22(2):240-73. DOI: https://doi.org/10.1128/cmr.00046-08

5. van de Veerdonk FL, Netea MG, Dinarello CA, Joosten LA. Inflammasome activation and IL-1β and IL-18 processing during infection. Trends Immunol. 2011;32(3):110-6. DOI: https://doi.org/10.1016/j.it.2011.01.003

6. Vallance P, Collier J, Bhagat K. Infection, inflammation, and infarction: does acute endothelial dysfunction provide a link? Lancet. 1997;349(9062):1391-2. DOI: https://doi.org/10.1016/s0140-6736(96)09424-x

7. Welt FGP, Shah PB, Aronow HD, Bortnick AE, Henry TD, Sherwood MW, et al. Catheterization Laboratory Considerations During the Coronavirus (COVID-19) Pandemic: From the ACC's Interventional Council and SCAI. J Am Coll Cardiol. 2020;75(18):2372-5. DOI: https://doi.org/10.1016/j.jacc.2020.03.021

8. Mahmud E, Dauerman HL, Welt FGP, Messenger JC, Rao SV, Grines C, et al. Management of Acute Myocardial Infarction During the COVID-19 Pandemic: A Position Statement From the Society for Cardiovascular Angiography and Interventions (SCAI), the American College of Cardiology (ACC), and the American College of Emergency Physicians (ACEP). J Am Coll Cardiol. 2020;76(11):1375-84. DOI: https://doi.org/10.1016/j.jacc.2020.04.039

9. Szerlip M, Anwaruddin S, Aronow HD, Cohen MG, Daniels MJ, Dehghani P, et al. Considerations for cardiac catheterization laboratory procedures during the COVID-19 pandemic perspectives from the Society for Cardiovascular Angiography and Interventions Emerging Leader Mentorship (SCAI ELM) Members and Graduates. Catheter Cardiovasc Interv. 2020;96(3):586-97. DOI: https://doi.org/10.1002/ccd.28887

10. Lim W, Qushmaq I, Devereaux PJ, Heels-Ansdell D, Lauzier F, Ismaila AS, et al. Elevated cardiac troponin measurements in critically ill patients. Arch Intern Med. 2006;166(22):2446-54. DOI: https://doi.org/10.1001/archinte.166.22.2446

11. Sarkisian L, Saaby L, Poulsen TS, Gerke O, Hosbond S, Jangaard N, et al. Prognostic Impact of Myocardial Injury Related to Various Cardiac and Noncardiac Conditions. Am J Med. 2016;129(5):506-14.e1. DOI: https://doi.org/10.1016/j.amjmed.2015.12.009

12. Sarkisian L, Saaby L, Poulsen TS, Gerke O, Jangaard N, Hosbond S, et al. Clinical Characteristics and Outcomes of Patients with Myocardial Infarction, Myocardial Injury, and Nonelevated Troponins. Am J Med. 2016;129(4):446.e5-e21. DOI: https://doi.org/10.1016/j.amjmed.2015.11.006

13. Smeeth L, Thomas SL, Hall AJ, Hubbard R, Farrington P, Vallance P. Risk of myocardial infarction and stroke after acute infection or vaccination. N Engl J Med. 2004;351(25):2611-8. DOI: https://doi.org/10.1056/nejmoa041747

14. Harrington RA. Targeting Inflammation in Coronary Artery Disease. N Engl J Med. 2017;377(12):1197-8. DOI: https://doi.org/10.1056/nejme1709904

15. Kwong JC, Schwartz KL, Campitelli MA, Chung H, Crowcroft NS, Karnauchow T, et al. Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. N Engl J Med. 2018;378(4):345-53. DOI: https://doi.org/10.1056/nejmoa1702090

16. Xiong TY, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: acute and long-term implications. Eur Heart J. 2020;41(19):1798-800. DOI: https://doi.org/10.1093/eurheartj/ehaa231

17. Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, et al. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic. J Am Coll Cardiol. 2020;75(18):2352-71. DOI: https://doi.org/10.1016/j.jacc.2020.03.031

18. 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;382(25):2478-80. DOI: https://doi.org/10.1056/nejmc2009020

19. Tan YK, Goh C, Leow AST, Tambyah PA, Ang A, Yap ES, et al. COVID-19 and ischemic stroke: a systematic review and meta-summary of the literature. J Thromb Thrombolysis. 2020;50(3):587-95. DOI: https://doi.org/10.1007/s11239-020-02228-y

20. Li Y, Li M, Wang M, Zhou Y, Chang J, Xian Y, et al. Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study. Stroke Vasc Neurol. 2020;5(3):279-84. DOI: https://doi.org/10.1136/svn-2020-000431

21. Lodigiani C, Iapichino G, Carenzo L, Cecconi M, Ferrazzi P, Sebastian T, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020;191:9-14. DOI: https://doi.org/10.1016/j.thromres.2020.04.024

22. Bilaloglu S, Aphinyanaphongs Y, Jones S, Iturrate E, Hochman J, Berger JS. Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System. JAMA. 2020;324(8):799-801. DOI: https://doi.org/10.1001/jama.2020.13372

23. Modin D, Claggett B, Sindet-Pedersen C, Lassen MCH, Skaarup KG, Jensen JUS, et al. Acute COVID-19 and the Incidence of Ischemic Stroke and Acute Myocardial Infarction. Circulation. 2020;142(21):2080-2. DOI: https://doi.org/10.1161/circulationaha.120.050809

24. Birnbaum Y, Sclarovsky S, Ben-Ami R, Rechavia E, Strasberg B, Kusniec J, et al. Polymorphous ventricular tachycardia early after acute myocardial infarction. Am J Cardiol. 1993;71(8):745-9. DOI: https://doi.org/10.1016/0002-9149(93)91021-9

25. Tomcsányi J, Marosi A, Bózsik B, Somlói M, Zsoldos A, Vecsey T, et al. N-terminal pro-brain natriuretic peptide and tombstoning ST-segment elevation in patients with anterior wall acute myocardial infarction. Am J Cardiol. 2005;96(9):1197-9. DOI: https://doi.org/10.1016/j.amjcard.2005.06.055

Descargas

Publicado

2022-11-02

Cómo citar

1.
Goire Guevara G. Infarto de miocardio en pacientes con COVID-19: Una complicación a tener en cuenta. CorSalud [Internet]. 2 de noviembre de 2022 [citado 25 de junio de 2025];14(3):286-92. Disponible en: https://revcorsalud.sld.cu/index.php/cors/article/view/888

Número

Sección

CASOS CLÍNICOS