{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:45:56Z","timestamp":1783507556422,"version":"3.55.0"},"reference-count":7,"publisher":"IMR Press","issue":"2","license":[{"start":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T00:00:00Z","timestamp":1593475200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Consideration 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.<\/jats:p>","DOI":"10.31083\/j.rcm.2020.02.92","type":"journal-article","created":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T07:12:31Z","timestamp":1593587551000},"source":"Crossref","is-referenced-by-count":10,"title":["High thrombus burden despite thrombolytic therapy in ST-elevation myocardial infarction in a patient with COVID-19"],"prefix":"10.31083","volume":"21","author":[{"given":"Gayatri","family":"Setia","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Tyler","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Kwan","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Faguet","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpa","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Azarbal","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Tompkins","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinora","family":"Chinchilla","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Ghandehari","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2020,6,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Bangalore, S., Sharma, A., Slotwiner, A., Yatskar, L., Harari, R., Shah, B., Ibrahim, H., Friedman, G. H., Thompson, C., Alviar, C. L., Chadow, H. L., Fishman, G. I., Reynolds, H. R., Keller, N. and Hochman, J. S. (2020) ST-Segment elevation in patients with Covid-19 - A case series. The New England Journal of Medicine 382, 2478-2480.","DOI":"10.1056\/NEJMc200902032302081https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32302081"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Campbell, C. M. and Kahwash, R. (2020) Will complement inhibition be the new target in treating COVID-19-related systemic thrombosis? Circulation 141, 1739-1741.","DOI":"10.1161\/CIRCULATIONAHA.120.04741932271624https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32271624"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Tan, C. W., Low, J. G. H., Wong, W. H., Chua, Y. Y., Goh, S. L. and Ng, H. J. (2020) Critically ill COVID-19 infected patients exhibit increased clot waveform analysis parameters consistent with hypercoagulability. 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J., American College of Cardiology\u2019s Interventional Council and the Society for Cardiovascular Angiography and Interventions (2020) Catheterization laboratory considerations during the Coronavirus (COVID-19) pandemic: From the ACC's Interventional Council and SCAI. Journal of the American College of Cardiology 75, 2372-2375.","DOI":"10.1016\/j.jacc.2020.03.02132199938https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32199938"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Xiong, T.-Y., Redwood, S., Prendergast, B. and Chen, M. (2020) Coronaviruses and the cardiovascular system: acute and long-term implications. 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