الفهرس 
Myocardial Infarction Secondary to Ischemic ImbalanceOnly 14 pages are availabe for public view
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Abstract
STEMI is a fatal cardiovascularemergency that requires rapid reperfusion treatment. (1) Reperfusion of the infarct-related coronary artery using percutaneous coronary intervention (PCI) is the optimum ST segment elevation myocardial infarction (STEMI) treatment to reduce infarct size, minimize myocardial damage, preserve ventricular function, and decrease morbidity and mortality. (2, 3) The European Society of Cardiology (ESC) and the American Heart Association (AHA) guidelines showed the superiority of primary PCI over the use of thrombolytic therapy in STEMI management. (4, 5) Despite these recommendations, recent data from the US National Cardiovascular Data Registry showed that only 51% of STEMI patients transferred for Primary PCI achieved the recommended first door to balloon time of less than 120 minutes. (6) Association of COVID-19 infection with STEMI worsen the prognosis of these patients due to delay from symptoms onset to first medical contact (FMC) and delay door to balloon time (time to reperfusion).(7) COVID-19 infection creates a prothrombotic state and leads to endothelial dysfunction mostly by cytokine-mediated systemic inflammatory response, prothrombotic activation of the coagulation cascade and hypoxic injury due to oxygen supply/demand imbalance which represent the main mechanisms in COVID-19 pathophysiology, so, COVID-19 infection increases the incidence of life-threatening thrombotic complications, such as ACS, venous thromboembolism (VTE) and pulmonary embolism (PE).