• Gayatri Setia, Jeffrey Tyler, Alan Kwan, Josh Faguet, Shilpa Sharma, Siddharth Singh, Babak Azarbal, Rose Tompkins, Dinora Chinchilla, and Sara Ghandehari.
• Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
• Rev Cardiovasc Med. 2020 Jun 30; 21 (2): 289-295.

AbstractConsideration of thrombolysis as first-line reperfusion therapy in patients with COVID-19 and STEMI is recommended by ACC/SCAI guidelines. We describe a patient with COVID-19, who presented with ST-elevation myocardial infarction and was treated with thrombolysis and anticoagulation. He was later found to have a significant persistent thrombus burden requiring thrombectomy and stent placement. Invasive hemodynamics on multiple high-dose pressers revealed a high cardiac output state with low systemic vascular resistance, consistent with distributive rather than cardiogenic shock. Our case illustrates that thrombolytic therapy alone may not be adequate in patients with STEMI and COVID-19, as well as the importance of early invasive hemodynamics in management of shock in patient with STEMI and COVID-19 infection.© 2020 Setia et al. Published by IMR press.

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