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| 55 year old, male admitted due
| 55 year old, male admitted due
to fever, cough and shortness of breath
to  


with suspected [[COVID-19]].
* fever,
* cough
* shortness of breath with suspected [[COVID-19]].


| Developed [[chest pain]] 48 hrs after admission  
| Developed [[chest pain]] 48 hrs after admission  
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|
|
* [[The electrocardiogram|EKG]]:  Inferior leads shows Inverted T waves.
* [[The electrocardiogram|EKG]]:  Inferior leads shows Inverted T waves.
*[[Troponin I]] was elevated {Hs-TnI was at 355 ng/l, then 570 ng/l
*[[Troponin I]]<nowiki> : Elevated  (355 ng/l --->70 ng/l 3 h later )[normal values <7 ng/l)]</nowiki>
 
3 h later (normal values <7 ng/l)}


* [[Transthoracic echocardiography]]:
* [[Transthoracic echocardiography]]:
**Left ventricular [[ejection fraction]]
**Left ventricular [[ejection fraction]] :60%  
 
**No abnormalities in wall motion.
60% wall motion had no abnormalities,
**Absence of [[Diastole|diastolic]] dysfunction
** absence of [[Diastole|diastolic]] dysfunction,
**Presence of mild [[mitral regurgitation]]
 
and presence of mild [[mitral regurgitation]]


* [[Coronary angiography|Coronary angiogram]] : Chronic total [[occlusion]] of the posterior
* [[Coronary angiography|Coronary angiogram]] : posterior


descending artery with [[epicardial]] collateral from the left anterior descending artery.
descending artery is occluded with [[epicardial]] collateral from the left anterior descending artery.


In the mid-right coronary artery, an intimal tear is present with a spontaneous dissecting coronary [[hematoma]]   
In tmid-right coronary artery, an intimal tear is present with a spontaneous dissecting coronary [[hematoma]]   


* Optical coherence tomography ([[Cardiac Optical Coherence Tomography (OCT)|OCT]]):  spontaneous dissecting coronary [[hematoma]] with an intimal rupture of right coronary artery
* Optical coherence tomography ([[Cardiac Optical Coherence Tomography (OCT)|OCT]]):  spontaneous dissecting coronary [[hematoma]] with an intimal rupture of right coronary artery
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* EKG: [[Precordium|precordial]] leads shows new ST-T abnormalities which was not present previously.
* EKG: [[Precordium|precordial]] leads shows new ST-T abnormalities which was not present previously.


[[Image:70yr.png|thumb|700px|right|frame|ST-T abnormalities in the precordial leads.]]<ref name="SeresiniAlbiero2020">{{cite journal|last1=Seresini|first1=Giuseppe|last2=Albiero|first2=Remo|last3=Liga|first3=Riccardo|last4=Camm|first4=Christian Fielder|last5=Liga|first5=Riccardo|last6=Camm|first6=Christian Fielder|last7=Thomson|first7=Ross|title=Atherosclerotic spontaneous coronary artery dissection (A-SCAD) in a patient with COVID-19: case report and possible mechanisms|journal=European Heart Journal - Case Reports|year=2020|issn=2514-2119|doi=10.1093/ehjcr/ytaa133}}</ref>
[[Image:70yr.png|thumb|700px|right|frame|ST-T abnormalities in the precordial leads.]]





Revision as of 16:56, 20 July 2020

  • Here is a table presenting symptoms of the reported cases:
Patient Symptoms Past medical history and risk factors Laboratory findings Treatment
55 year old, male admitted due

to

  • fever,
  • cough
  • shortness of breath with suspected COVID-19.
Developed chest pain 48 hrs after admission Peripheral artery disease
  • EKG: Inferior leads shows Inverted T waves.
  • Troponin I : Elevated (355 ng/l --->70 ng/l 3 h later )[normal values <7 ng/l)]

descending artery is occluded with epicardial collateral from the left anterior descending artery.

In tmid-right coronary artery, an intimal tear is present with a spontaneous dissecting coronary hematoma

  • Optical coherence tomography (OCT): spontaneous dissecting coronary hematoma with an intimal rupture of right coronary artery
  • Coronary angiogram was planned.
70-year-old, male Severe , persistent chest pain ( 8/10), which started 3 hrs before admission Smoking, Hypertension, and Type 2 diabetes,

H/O percutaneous coronary intervention (PCI) with implantation of a drug-eluting stent (DES)

  • EKG: precordial leads shows new ST-T abnormalities which was not present previously.
ST-T abnormalities in the precordial leads.


48‐year‐old, female History of severe chest pain that awoke her from sleep,9/10,severe,retrosternal tightness,pain radiates to neck and both arms. Migraine and Hyperlipidemia