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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).

Publication ,  Journal Article
Mahmud, E; Dauerman, HL; Welt, FGP; Messenger, JC; Rao, SV; Grines, C; Mattu, A; Kirtane, AJ; Jauhar, R; Meraj, P; Rokos, IC; Rumsfeld, JS; Henry, TD
Published in: J Am Coll Cardiol
September 15, 2020

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.

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

September 15, 2020

Volume

76

Issue

11

Start / End Page

1375 / 1384

Location

United States

Related Subject Headings

  • United States
  • Thrombolytic Therapy
  • SARS-CoV-2
  • Risk Assessment
  • Pneumonia, Viral
  • Percutaneous Coronary Intervention
  • Pandemics
  • Organizational Innovation
  • Myocardial Infarction
  • Infection Control
 

Citation

APA
Chicago
ICMJE
MLA
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Mahmud, E., Dauerman, H. L., Welt, F. G. P., Messenger, J. C., Rao, S. V., Grines, C., … Henry, T. D. (2020). 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). J Am Coll Cardiol, 76(11), 1375–1384. https://doi.org/10.1016/j.jacc.2020.04.039
Mahmud, Ehtisham, Harold L. Dauerman, Frederick G. P. Welt, John C. Messenger, Sunil V. Rao, Cindy Grines, Amal Mattu, et al. “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).J Am Coll Cardiol 76, no. 11 (September 15, 2020): 1375–84. https://doi.org/10.1016/j.jacc.2020.04.039.
Mahmud E, Dauerman HL, Welt FGP, Messenger JC, Rao SV, Grines C, Mattu A, Kirtane AJ, Jauhar R, Meraj P, Rokos IC, Rumsfeld JS, Henry TD. 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). J Am Coll Cardiol. 2020 Sep 15;76(11):1375–1384.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

September 15, 2020

Volume

76

Issue

11

Start / End Page

1375 / 1384

Location

United States

Related Subject Headings

  • United States
  • Thrombolytic Therapy
  • SARS-CoV-2
  • Risk Assessment
  • Pneumonia, Viral
  • Percutaneous Coronary Intervention
  • Pandemics
  • Organizational Innovation
  • Myocardial Infarction
  • Infection Control