Problems of care for STEMI patients in coronavirus pandemic

The covid-19 pandemic negatively affects time-dependent care and the course of STEMI in several aspects: Some patients delay seeking emergency care or even do not call it at all because of fear of contracting covid-19 at hospitals. The presentations of STEMI and covid-19 can overlap and mimic each other. Both conditions may coexist. Uncertainty regarding diagnosis may add to delays. Provider΄s concerns about the covid-19 infection or lack of cath lab staff may lead to changes in treatment algorhithms. There may also be delay due to the infection-control measures employed by medical staff. Reduction in non-covid care, overwhelmed emergency medical services and hospitals, staff-absences, and lack of beds may all lead to treatment delay or even inability to provide it. Inflammatory and prothrombotic states in patients with covid-19 increase the risk of developing STEMI as well as that of STEMI complications. Hypoxia due to covid-19 lung disease deepens myocardial ischemia during STEMI and may extend the volume of STEMI and increase the risk of heart failure. Covid myocarditis Conclusion: It is apparent that STEMI in covid-19 infected patients is not the same disease process as STEMI that without covid-19 infection. Patients with STEMI and covid-19 have a higher risk of heart failure, cardiac arrest, cardiogenic shock, greater intracoronary thrombosis and stent thrombosis, resulting in higher cardiac and non-cardiac mortality. Aggressive antithrombotic treatment is recommended. Even in the covid era it is essential to insist on timely treatment of STEMI. Training of cardiac catheterization personnel on how to use personal protective equipment as well as vaccination are crucial to limit the risk of acquiring infection. (English) [ABSTRACT FROM AUTHOR] Infekce covid-19 a covidova pandemie představuji problem pro peci o nemocne se STEMI. Výskyt, průběh, lecbu a prognozu STEMI ovlivňuje covidova epidemie v několika aspektech: „ Cast nemocných z obavy před covidovou nakazou v nemocnici oddaluje přivolani zdravotnicke pomoci, nebo dokonce pomoc vůbec nezavola. Přiznaky STEMI a covid-19 se mohou překrývat a vzajemně napodobovat, navic mohou koexistovat, nejistota při stanoveni diagnozy může vest ke zpožděni lecby. Obava z covidove nakazy zdravotniků nebo nedostatek personalu katetrizacnich laboratoři může vest ke změně lecebných algoritmů. Přetižene zdravotni služby, omezeni „necovidove“ pece, chybějici personal, nedostatek lůžek mohou mit za nasledek prodlevu v lecbě STEMI až nemožnost lecbu poskytnout. Použiti ochranných prostředků proti siřeni covid-19 může vest ke zpožděni lecby. Zanětlivý a protrombotický stav během covidove infekce zvysuje riziko vzniku infarktu myokardu a zvysuje riziko trombotických komplikaci již probihajiciho STEMI. Hypoxie způsobena covidovým postiženim plic prohlubuje ischemii myokardu při AIM, může zvětsit rozsah infarktu a zvysuje riziko srdecniho selhani při AIM. Covidova myokarditida. Zavěr: STEMI u nemocneho s covid-19 neni stejna nemoc jako STEMI bez covid-19. Nemocni s covid-19 a STEMI maji castěji srdecni selhani a srdecni zastavu, rozsahlejsi intrakoronarni trombozu, významně vyssi riziko akutni trombozy stentu, kardiogenniho soku po PCI a významně vyssi nemocnicni kardialni i nekardialni mortalitu. Je indikovana agresivnějsi antitromboticka lecba. I v covidove době je nutna maximalni snaha o co nejrychlejsi zajistěni reperfuzni lecby a dodrženi casových limitů pro jeji provedeni. Velmi důležite jsou nacvik použivani ochranných pomůcek proti siřeni infekce a vakcinace. (Czech) [ABSTRACT FROM AUTHOR] Copyright of Intervencni a Akutni Kardiologie is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)