Fast Five Quiz: Myocardial Infarction Clinical Keys

Yasmine S. Ali, MD

Disclosures

November 13, 2020

According to a consensus statement on the management of acute MI during the COVID-19 pandemic, primary PCI remains the standard of care for patients presenting to PCI centers (≤ 90 minutes of first medical contact) during the COVID-19 pandemic. Each primary PCI center should monitor the ability to provide timely primary PCI on the basis of availability of staff and personal protective equipment; need for additional testing; and need for a designated CCL, which will require terminal cleaning after each procedure. In the absence of these resources, a fibrinolysis-first approach should be considered.

Owing to the logistical issues and time delays secondary to diagnostic uncertainty of STEMI with COVID-19, direct transport of the patient to the CCL is not recommended. The consensus statement recommends initial assessment of all patients with STEMI in the emergency department during the COVID-19 pandemic. The attending interventional cardiologist should be notified without activation of the entire STEMI team until the plan for CCL activation is confirmed.

This consensus statement notes that not all patients with COVID-19 who have ST elevation with or without an acute coronary occlusion will benefit from any reperfusion strategy or advanced mechanical support.

Read more clinical guidance about COVID-19.

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