Management of Acute Myocardial Infarction During the COVID-19 Pandemic: A Position Statement From the Society for Cardiovascular Angiography and Interventions (SCAI), the American College of Cardiology (ACC), and the American College of Emergency Physicians (ACEP)
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Author
Mahmud, EhtishamDauerman, Harold L
Messenger, John C
Rao, Sunil V
Grines, Cindy
Mattu, Amal
Kirtane, Ajay J
Jauhar, Rajiv
Meraj, Perwaiz
Rokos, Ivan C
Rumsfeld, John S
Henry, Timothy D
Welt, Frederick Gp
Date
2020-09-15Journal
Journal of the American College of CardiologyPublisher
Elsevier Ltd.Type
ArticleOther
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Show full item recordAbstract
The worldwide pandemic caused by the novel acute respiratory syndrome coronavirus 2 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 this novel coronavirus. 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 an ST-elevation myocardial infarction (STEMI) presentation, stress cardiomyopathy, non-ischemic cardiomyopathy, coronary spasm, or nonspecific myocardial injury, and the prevalence of COVID-19 disease in the U.S. 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.Rights/Terms
Copyright © 2020 American College of Cardiology Foundation and Wiley Periodicals, Inc. Published by Elsevier Inc. All rights reserved.Keyword
COVID-19STEMI
acute myocardial infarction
emergency medical system
fibrinolysis
percutaneous coronary intervention
Identifier to cite or link to this item
http://hdl.handle.net/10713/13651ae974a485f413a2113503eed53cd6c53
10.1016/j.jacc.2020.04.039
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