Management of Acute Myocardial Infarction During the COVID-19 Pandemic.
Identifieur interne : 000340 ( Main/Corpus ); précédent : 000339; suivant : 000341Management of Acute Myocardial Infarction During the COVID-19 Pandemic.
Auteurs : Ehtisham Mahmud ; Harold L. Dauerman ; Frederick Gp Welt ; John C. Messenger ; Sunil V. Rao ; Cindy Grines ; Amal Mattu ; Ajay J. Kirtane ; Rajiv Jauhar ; Perwaiz Meraj ; Ivan C. Rokos ; John S. Rumsfeld ; Timothy D. HenrySource :
- Journal of the American College of Cardiology [ 1558-3597 ] ; 2020.
Abstract
The worldwide pandemic caused by the novel acute respiratory syndrome coronavirus 2 (SARS-CoV2) has resulted in a new and lethal disease termed coronavirus disease 2019 (COVID-19). Although there is an association between cardiovascular disease and COVID-19, the majority of patients who need cardiovascular care for the management of ischemic heart disease may not be infected with COVID-19. The objective of this document is to provide recommendations for a systematic approach for the care of patients with an acute myocardial infarction (AMI) during the COVID-19 pandemic. There is a recognition of two major challenges in providing recommendations for AMI care in the COVID-19 era. Cardiovascular manifestations of COVID-19 are complex with patients presenting with AMI, myocarditis simulating a ST-elevation MI presentation, stress cardiomyopathy, non-ischemic cardiomyopathy, coronary spasm, or nonspecific myocardial injury and the prevalence of COVID-19 disease in the US population remains unknown with risk of asymptomatic spread. This document addresses the care of these patients focusing on 1) the varied clinical presentations; 2) appropriate personal protection equipment (PPE) for health care workers; 3) role of the Emergency Department, Emergency Medical System and the Cardiac Catheterization Laboratory; and 4) Regional STEMI systems of care. During the COVID-19 pandemic, primary PCI remains the standard of care for STEMI patients at PCI capable hospitals when it can be provided in a timely fashion, with an expert team outfitted with PPE in a dedicated CCL room. A fibrinolysis-based strategy may be entertained at non-PCI capable referral hospitals or in specific situations where primary PCI cannot be executed or is not deemed the best option.
DOI: 10.1016/j.jacc.2020.04.039
PubMed: 32330544
PubMed Central: PMC7173829
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<front><div type="abstract" xml:lang="en">The worldwide pandemic caused by the novel acute respiratory syndrome coronavirus 2 (SARS-CoV2) has resulted in a new and lethal disease termed coronavirus disease 2019 (COVID-19). Although there is an association between cardiovascular disease and COVID-19, the majority of patients who need cardiovascular care for the management of ischemic heart disease may not be infected with COVID-19. The objective of this document is to provide recommendations for a systematic approach for the care of patients with an acute myocardial infarction (AMI) during the COVID-19 pandemic. There is a recognition of two major challenges in providing recommendations for AMI care in the COVID-19 era. Cardiovascular manifestations of COVID-19 are complex with patients presenting with AMI, myocarditis simulating a ST-elevation MI presentation, stress cardiomyopathy, non-ischemic cardiomyopathy, coronary spasm, or nonspecific myocardial injury and the prevalence of COVID-19 disease in the US population remains unknown with risk of asymptomatic spread. This document addresses the care of these patients focusing on 1) the varied clinical presentations; 2) appropriate personal protection equipment (PPE) for health care workers; 3) role of the Emergency Department, Emergency Medical System and the Cardiac Catheterization Laboratory; and 4) Regional STEMI systems of care. During the COVID-19 pandemic, primary PCI remains the standard of care for STEMI patients at PCI capable hospitals when it can be provided in a timely fashion, with an expert team outfitted with PPE in a dedicated CCL room. A fibrinolysis-based strategy may be entertained at non-PCI capable referral hospitals or in specific situations where primary PCI cannot be executed or is not deemed the best option.</div>
</front>
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<Title>Journal of the American College of Cardiology</Title>
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<ArticleTitle>Management of Acute Myocardial Infarction During the COVID-19 Pandemic.</ArticleTitle>
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<Abstract><AbstractText>The worldwide pandemic caused by the novel acute respiratory syndrome coronavirus 2 (SARS-CoV2) has resulted in a new and lethal disease termed coronavirus disease 2019 (COVID-19). Although there is an association between cardiovascular disease and COVID-19, the majority of patients who need cardiovascular care for the management of ischemic heart disease may not be infected with COVID-19. The objective of this document is to provide recommendations for a systematic approach for the care of patients with an acute myocardial infarction (AMI) during the COVID-19 pandemic. There is a recognition of two major challenges in providing recommendations for AMI care in the COVID-19 era. Cardiovascular manifestations of COVID-19 are complex with patients presenting with AMI, myocarditis simulating a ST-elevation MI presentation, stress cardiomyopathy, non-ischemic cardiomyopathy, coronary spasm, or nonspecific myocardial injury and the prevalence of COVID-19 disease in the US population remains unknown with risk of asymptomatic spread. This document addresses the care of these patients focusing on 1) the varied clinical presentations; 2) appropriate personal protection equipment (PPE) for health care workers; 3) role of the Emergency Department, Emergency Medical System and the Cardiac Catheterization Laboratory; and 4) Regional STEMI systems of care. During the COVID-19 pandemic, primary PCI remains the standard of care for STEMI patients at PCI capable hospitals when it can be provided in a timely fashion, with an expert team outfitted with PPE in a dedicated CCL room. A fibrinolysis-based strategy may be entertained at non-PCI capable referral hospitals or in specific situations where primary PCI cannot be executed or is not deemed the best option.</AbstractText>
<CopyrightInformation>Copyright © 2020 American College of Cardiology Foundation and Wiley Periodicals, Inc. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
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<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mahmud</LastName>
<ForeName>Ehtisham</ForeName>
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<Author ValidYN="Y"><LastName>Dauerman</LastName>
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<Author ValidYN="Y"><LastName>Welt</LastName>
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<Author ValidYN="Y"><LastName>Rao</LastName>
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<Initials>AJ</Initials>
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</AffiliationInfo>
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<Initials>P</Initials>
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</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Rokos</LastName>
<ForeName>Ivan C</ForeName>
<Initials>IC</Initials>
<AffiliationInfo><Affiliation>Methodist Hospital of Southern California, Arcadia CA.</Affiliation>
</AffiliationInfo>
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<AffiliationInfo><Affiliation>University of Colorado Medical School, Denver CO.</Affiliation>
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<Author ValidYN="Y"><LastName>Henry</LastName>
<ForeName>Timothy D</ForeName>
<Initials>TD</Initials>
<AffiliationInfo><Affiliation>The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati OH.</Affiliation>
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<Keyword MajorTopicYN="N">STEMI</Keyword>
<Keyword MajorTopicYN="N">acute myocardial infarction</Keyword>
<Keyword MajorTopicYN="N">emergency medical system</Keyword>
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