PMID- 36407273
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221122
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 10
DP  - 2022 Oct
TI  - Prolonged Use of Tirofiban Infusion Without Percutaneous Coronary Intervention To 
      Achieve Optimal Results in a COVID-19 Positive Patient With Inferior ST Segment 
      Elevated Myocardial Infarction (STEMI) Secondary to Thromboembolism: A Case 
      Report.
PG  - e30287
LID - 10.7759/cureus.30287 [doi]
LID - e30287
AB  - Severe acute respiratory syndrome‑coronavirus‑2 (SARS‑CoV‑2), responsible for 
      COVID-19, is mainly a respiratory illness, but it can affect other organs also 
      such as heart, kidneys, and liver. Myocardial injury from COVID-19 has been 
      reported in hospitalized patients ranging from pericarditis and myocarditis to 
      acute coronary syndrome (ACS). COVID-19 is highly hypercoagulable state and is 
      associated with both central and peripheral thromboembolism. COVID 19 patients 
      with ACS may not present with classical features of chest pain and 
      electrocardiogram (ECG) is the most important initial investigation in these 
      patients to assess for any ST or T waves changes. COVID-19 patients with cardiac 
      involvement are the most vulnerable group of patients and have increased 
      morbidity and mortality risk. COVID-19 infections can affect the cardiovascular 
      system in patients with or without history of coronary artery disease (CAD), but 
      the risk of type 1 or 2 myocardial infarction (MI), myocardial injury, ST segment 
      elevation, myocarditis, heart failure, cardiogenic shock, and life threatening 
      arrhythmias are more common in the former group. We present a case of 55-year-old 
      patient who presented to our cardiac center with ST elevated myocardial 
      infarction and high blood sugar level. Patient was recently diagnosed with type 2 
      diabetes mellitus (T2DM) but was not commenced on medications. Echocardiogram 
      showed mildly impaired left ventricular systolic function (LVSF) with inferior 
      wall hypokinesia, and ECG showed inferior leads ST elevation. Coronary angiogram 
      showed severe mid-vessel lesion and occluded posterior left ventricular branch 
      (PLV). Multiple attempts at aspirating the thrombus resulted in thrombolysis in 
      MI grade 2 (TIMI 2) flow in the vessel and patient was commenced on a tirofiban 
      infusion for 72 hours.
CI  - Copyright (c) 2022, Khan et al.
FAU - Khan, Zahid
AU  - Khan Z
AD  - Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend on Sea, GBR.
AD  - Cardiology and General Medicine, Barking, Havering and Redbridge University 
      Hospitals NHS Trust, London, GBR.
AD  - Cardiology, Royal Free Hospital, London, GBR.
FAU - Patel, Niket
AU  - Patel N
AD  - Cardiology, Royal Free Hospital, London, GBR.
LA  - eng
PT  - Case Reports
DEP - 20221014
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9654896
OTO - NOTNLM
OT  - covid 19
OT  - covid 19 associated acute coronary syndrome
OT  - diabetes type 2
OT  - electrocardiogram (ecg/ekg)
OT  - non-peptidal antagonist of the gp iib/iiia receptor
OT  - sliding scale
OT  - st-elevation myocardial infarction (stemi)
OT  - thrombo embolic disease
OT  - tirofiban
OT  - ultrasonic aspiration
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/11/22 06:00
MHDA- 2022/11/22 06:01
PMCR- 2022/10/14
CRDT- 2022/11/21 04:30
PHST- 2022/10/14 00:00 [accepted]
PHST- 2022/11/21 04:30 [entrez]
PHST- 2022/11/22 06:00 [pubmed]
PHST- 2022/11/22 06:01 [medline]
PHST- 2022/10/14 00:00 [pmc-release]
AID - 10.7759/cureus.30287 [doi]
PST - epublish
SO  - Cureus. 2022 Oct 14;14(10):e30287. doi: 10.7759/cureus.30287. eCollection 2022 
      Oct.