PMID- 38074884
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231211
IS  - 2405-8440 (Print)
IS  - 2405-8440 (Electronic)
IS  - 2405-8440 (Linking)
VI  - 9
IP  - 11
DP  - 2023 Nov
TI  - Simultaneous acute portal vein thrombosis and ST elevation myocardial infarction 
      in a Covid-19 patient - Case report.
PG  - e22301
LID - 10.1016/j.heliyon.2023.e22301 [doi]
LID - e22301
AB  - BACKGROUND: Covid-19 infected patients without any risk factors and family 
      history of a thrombotic event can be still at risks of developing thrombotic 
      and/or other Covid-19-related complications, and therefore, there is a 
      substantial need to study such cases. CASE PRESENTATION: In this study, we 
      present a 60-years-old Covid-19 patient with mild symptoms who was admitted to 
      the hospital with simultaneous arterial and venous thrombotic event, with chief 
      complaint of chest pain and vague abdominal pain. The patient was diagnosed with 
      Covid-19 two weeks before admission to the ICU. A 12-lead electrocardiogram 
      revealed pathologic Q-wave ST-segment elevation and T-wave inversion in II, III, 
      aVF, and T inversion in V5 and V6. Quantitative troponin was elevated which 
      confirmed inferior ST-elevation MI. Abdominal color Doppler sonography and CT 
      scan with contrast demonstrated an absent flow in the portal vein and thrombosis. 
      A chest CT scan illustrated a normal pattern. We started IV unfractionated 
      heparin (UFH), dual antiplatelet, beta-blocker, statin, intravenous nitrate, and 
      angiotensin-converting enzyme inhibitor. Coronary angiography showed the right 
      coronary artery was totally cut off at the proximal part.Here we report three 
      main un-common characteristics associated with our patient compared to other 
      similar studies. First, the thrombotic event in our case occurred without 
      pulmonary involvement and the patient only had a flu-like symptom two weeks 
      before admission. The second main difference is that the patient's arterial and 
      venous thrombotic events had simultaneously happened, which is not common in most 
      cases. Patient presented simultaneous portal vein thrombosis and recent 
      ST-segment elevation Myocardial Infarction (MI). Finally, both MI and portal vein 
      thrombosis symptoms were subtle and confusing, which could cause misdiagnosis. A 
      post two-weeks color Doppler sonography follow-up showed portal vein thrombosis 
      recanalization and myocardial perfusion scan had no viability and reversible 
      ischemia in RCA territory. CONCLUSIONS: This report addresses that a cautious 
      diagnosis of Covid-19 at the time of admission can play a vital role in 
      preventing cardiovascular events; where even asymptomatic to mildly infected 
      patients could be still at higher risks of developing clinical complications 
      (e.g., thrombotic events).
CI  - (c) 2023 The Authors.
FAU - Nournia, Ensieh
AU  - Nournia E
AD  - Cardiologist at Be'sat Hospital, Hamedan University of Medical Sciences, Hamedan, 
      Iran.
FAU - Abbasi, Hamid
AU  - Abbasi H
AD  - Auckland Bioengineering Institute, University of Auckland, Auckland, 1010, New 
      Zealand.
FAU - Bazrafshan, Maziar
AU  - Bazrafshan M
AD  - Vascular Surgeon at Be'sat Hospital, Hamedan University of Medical Sciences, 
      Hamedan, Iran.
LA  - eng
PT  - Case Reports
DEP - 20231117
PL  - England
TA  - Heliyon
JT  - Heliyon
JID - 101672560
PMC - PMC10700385
OTO - NOTNLM
OT  - Acute portal vein thrombosis
OT  - Case report
OT  - Covid-19
OT  - NonVitamin K antagonist oral anticoagulants (NOAC)
OT  - ST elevation myocardial infarction
COIS- The authors declare that they have no known competing financial interests or 
      personal relationships that could have appeared to influence the work reported in 
      this paper.
EDAT- 2023/12/11 06:45
MHDA- 2023/12/11 06:46
PMCR- 2023/11/17
CRDT- 2023/12/11 05:49
PHST- 2022/08/13 00:00 [received]
PHST- 2023/11/08 00:00 [revised]
PHST- 2023/11/09 00:00 [accepted]
PHST- 2023/12/11 06:46 [medline]
PHST- 2023/12/11 06:45 [pubmed]
PHST- 2023/12/11 05:49 [entrez]
PHST- 2023/11/17 00:00 [pmc-release]
AID - S2405-8440(23)09509-9 [pii]
AID - e22301 [pii]
AID - 10.1016/j.heliyon.2023.e22301 [doi]
PST - epublish
SO  - Heliyon. 2023 Nov 17;9(11):e22301. doi: 10.1016/j.heliyon.2023.e22301. 
      eCollection 2023 Nov.