Tahniyath, Uzma and Kiran, P. Madhu and Pravala, E. Navya and joshi, M. Aarthi (2024) Unmasking the Clinical Characteristics, Outcomes and Assessing the Frequency and Consequences of Silent Myocardial Infarction in Asymptomatic COVID-19 Survivors: A Multi Centre Study. Asian Journal of Research in Cardiovascular Diseases, 6 (1). pp. 93-104.
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Abstract
A condition known as silent myocardial ischemia occurs when there is a decrease in myocardial blood flow without any obvious signs, such as discomfort or chest pain. The most typical clinical manifestation of coronary artery disease (CAD) is this illness. [1] Silent myocardial infarction is detected by electrocardiogram (ECG), echocardiography, and perfusion abnormalities. Even though some patients do not have a history of CAD, silent myocardial ischemia is common in those with stable CAD. Silent ischemia is a highly reliable indicator of death. Silent ischemia, or anginal chest symptoms, are absent in about 70–80% of transitory ischemic episodes [2]. When myocardial ischemia is quiet, patients do not seek medical attention in a timely manner, which increases morbidity and mortality. Patients with diabetes mellitus (DM) who are older and have a history of myocardial infarction or revascularization are at risk. The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has introduced numerous medical complexities, particularly affecting cardiovascular health [3]. Among these, silent heart attacks, or silent myocardial infarctions (SMIs), pose a significant risk yet often go undetected due to their lack of overt symptoms. This article explores the intricate relationship between silent heart attacks and COVID-19, examining the mechanisms through which the virus exacerbates cardiovascular strain, including direct myocardial infection, systemic inflammation, and increased thrombosis risk [4]. Myocarditis, arrhythmias, and myocardial infarctions (MIs) are among the cardiovascular consequences that are increasingly known to be associated with an elevated risk during and after COVID-19 infection. In addition to possible thrombotic and inflammatory pathways, direct virally-induced damage are the mechanisms causing severe consequences. According to the latter, factors that contribute to MI-induced post-COVID-19 consequences are explored, including inflammatory plaque instability and plaque rupture [5]. Our case report details the first instance in which invasive (OCT) and non-invasive (CMR) modalities are used to uncover a silent MI caused by coronary plaque rupture due to a transient reduction of LVEF during the COVID-19 convalescence phase. When COVID-19 patients worsen, it may be necessary to rule out myocardial infarction as a differential diagnosis, particularly if dyspnea continues after an acute infection [6]. The overlap of COVID-19 symptoms with those of silent heart attacks complicates detection, necessitating vigilant cardiac monitoring and the use of biomarkers and imaging. The presence of silent heart attacks in COVID-19 patients worsens their prognosis, highlighting the need for comprehensive management strategies that include regular monitoring, anticoagulation therapy, and anti-inflammatory treatments. Understanding this interplay is crucial for improving patient outcomes and guiding effective prevention and treatment measures [7].
Item Type: | Article |
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Subjects: | Middle East Library > Medical Science |
Depositing User: | Unnamed user with email support@middle-eastlibrary.com |
Date Deposited: | 26 Oct 2024 09:50 |
Last Modified: | 26 Oct 2024 09:50 |
URI: | http://editor.openaccessbook.com/id/eprint/1533 |