| Abstract [eng] |
Ischemic heart disease (CHD) is the leading cause of death in Lithuania and around the world. Mortality from acute ST elevation myocardial infarction can reach 30-40% if the disease is not diagnosed in time and blood flow is not restored immediately. Prolonged myocardial ischaemia was observed in these patients during the pandemic because 1) there was a fear of the virus in the community, which prevented patients from seeking help; 2) due to additional infection control measures, the examination time of patients was extended. In this final work, I describe the two clinical cases of acute myocardial infarction that were treated during the VUL SK pandemic, review the diagnostic features, and provide a related literature review. Diagnosis of acute myocardial infarction with ST segment elevation begins at the time of first medical contact and is based on the patient's complaints, medical and life history, as well as changes in the electrocardiogram (ECG). The disease usually presents with typical symptoms of myocardial ischemia and specific ST-segment elevation, with less frequent atypical symptoms and / or non-specific electrocardiographic changes, which complicates diagnosis and delays appropriate treatment. Testing for SARS-CoV-2 is mandatory for all patients, but there are a few exceptions — those who are ill, recovered, or vaccinated under the scheme, but if emergency care is needed, it is started without waiting for a response. The expected time from diagnosis to vascular opening should be considered in the choice of treatment tactics. During a pandemic, the recommended time of 120 minutes was usually extended to an 60 minutes due to additional infection control requirements. Irrespective of infection with coronavirus infection, percutaneous coronary intervention (PCI) is preferred. Medication is recommended in patients with a poor prognosis due to COVID-19 complications. |
