Beware of the Unexpected: Acute Coronary Thrombosis Following the Mildly Symptomatic COVID-19 Infection and Two Different Therapeutic Options

Abstract

COVID-19 infection was declared a pandemic in March 2020 and is responsible for high morbidity and morta-lity around the globe. Although the most common clinical presentation is respiratory, cardiac complications are common and create new challenges for healthcare. We discuss two mildly symptomatic outpatients with COVID-19 presenting with acute ST-elevation myocardial infarction (STEMI) and high coronary thrombus burden without atherosclerotic plaque. Our report describes two different therapeutic approaches that illustrate the challenges encountered in the management of disseminated coronary thrombosis in patients with STEMI and COVID-19. Clinicians should be aware of the high pro-coagulant state caused by COVID-19, even in mildly symptomatic outpatients, and aggressive pharmacological therapy may be an effective alter- native treatment option to percutaneous coronary intervention.