Compared with fibrinolytic therapy, reperfusion through primary angioplasty is more reliable and durable, and has less complications. This results in a higher net clinical benefit, both in terms of mortality and of reinfarction and bleeding. In the midst of the COVID-19 pandemic, the discussion on the usefulness of thrombolysis has emerged once again. Some societies…
In Favor of the Use of Thrombolytics in Pandemic Times
The Covid-19 pandemic has dramatically altered reperfusion therapy access in patients undergoing ST elevation MI. In these adverse times, it seems prudent to reassess the reperfusion algorithm. Even though primary PCI is the standard reperfusion strategy, to fully benefit from it is essential to keep first medical-contact-to-PCI time between 90 to 120 minutes (depending on…
Management of Infarction During the COVID-19 Pandemic
Patients with cardiovascular disease infected with COVID-19 are at a particular risk for morbidity and mortality. In any case, it should be noted that most patients requiring cardiovascular care due to ischemic heart disease, peripheral vascular disease, or structural heart disease are not infected. Being prepared to face this pandemic is as important as guaranteeing…
Thrombosis and Thromboembolism Associated with COVID-19
Coronavirus disease 2019 (COVID-19) is a viral respiratory illness that can cause a severe acute respiratory syndrome (SARS-CoV-2), predisposing patients to thrombosis (both in veins and arteries) due to excessive inflammation, platelet activation, endothelial dysfunction, and stasis. In addition, many patients receiving antithrombotic therapy for different indications may now become infected with COVID-19, which can…
How is the Pandemic Affecting MI? The Chinese Experience
ST elevation acute myocardial infarction has high mortality and morbidity rates. It is normally treated with primary PCI. The whole system has established very effective protocols to minimize ischemic time from symptom onset to definite treatment in the cath lab. This study reports the experience in Hong Kong since January 2020, when all emergency protocols…
ECS Guidelines for COVID-19 Management
One of the first statements in this document points out these are not “regular guidelines” developed after thorough analysis of all the available evidence published since the last update. Instead, they are meant to provide temporary basic management pointers on how to handle different scenarios of cardiac patients in the context of the COVID-19 pandemic.…
ST-Segment Elevation Myocardial Infarction in the Time of COVID-19
This study cites the experience of 6 sites during the first month of the COVID-19 pandemic in New York. All patients included had a confirmed diagnosis of coronavirus infection and also ST-segment elevation on electrocardiography. Eighteen patients met these criteria. We are used to large randomized studies; consequently, this small registry of less than 20 people seems to…
Procedural Rescheduling Criteria in the Pandemic Era
Patients with structural heart disease are at higher risk in the face of the new coronavirus infection due to both advanced age and numerous comorbidities. All variables must be taken into account when deciding whether a patient can wait (so as to minimize the risk of exposure to the virus) or their pathology must be…
Is There a Relationship between ARBs, ACE 2 Inhibitors and COVID-19?
In the past few days, many doctors appear to have caught wind of somewhat unfounded data. According to this information, the novel COVID-19 would use angiotensin converting enzyme 2 (ACE2) receptors to enter cells and, in this context, patients with an upregulated expression of these receptors (such as patients receiving angiotensin converting enzyme (ACE) inhibitors…
Cath Lab Management Protocol for the COVID-19 Outbreak
The Interventional Cardiology Association and the Cardiac Beat Association from the Spanish Society of Cardiology have released a document stating all the available information on the COVID-19 outbreak for interventionists to tackle this health crisis to the best of their ability. ” Abstract “During March 2020, the SARS-CoV-2 virus has spread throughout Europe, with special…