Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Sep 2020
Observational StudyHigh Thrombus Burden in Patients With COVID-19 Presenting With ST-Segment Elevation Myocardial Infarction.
Coronavirus disease-2019 (COVID-19) is thought to predispose patients to thrombotic disease. To date there are few reports of ST-segment elevation myocardial infarction (STEMI) caused by type 1 myocardial infarction in patients with COVID-19. ⋯ In patients presenting with STEMI and concurrent COVID-19 infection, there is a strong signal toward higher thrombus burden and poorer outcomes. This supports the need for establishing COVID-19 status in all STEMI cases. Further work is required to understand the mechanism of increased thrombosis and the benefit of aggressive antithrombotic therapy in selected cases.
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J. Am. Coll. Cardiol. · Sep 2020
ReviewCardiac Troponin for Assessment of Myocardial Injury in COVID-19: JACC Review Topic of the Week.
Increases in cardiac troponin indicative of myocardial injury are common in patients with coronavirus disease-2019 (COVID-19) and are associated with adverse outcomes such as arrhythmias and death. These increases are more likely to occur in those with chronic cardiovascular conditions and in those with severe COVID-19 presentations. ⋯ Myocarditis, stress cardiomyopathy, acute heart failure, and direct injury from SARS-CoV-2 are important etiologies, but primary noncardiac conditions, such as pulmonary embolism, critical illness, and sepsis, probably cause more of the myocardial injury. The structured use of serial cardiac troponin has the potential to facilitate risk stratification, help make decisions about when to use imaging, and inform stage categorization and disease phenotyping among hospitalized COVID-19 patients.
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J. Am. Coll. Cardiol. · Aug 2020
Survival and Right Ventricular Function After Surgical Management of Acute Pulmonary Embolism.
Acute pulmonary embolism (PE) is associated with high morbidity and mortality because of right ventricular (RV) failure. There is evidence suggesting surgical therapy (surgical embolectomy or venoarterial extracorporeal membrane oxygenation [ECMO]) is safe and effective. ⋯ Surgical management of patients with MPE and high-risk SMPE is safe and highly effective at achieving RV recovery.