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Authors | Diakite et al. [4] | Alao et al. [5] | Shin et al. [6] | Qavi et al. |
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Publication year | 2021 | 2022 | 2022 | Present case |
Race | Sub-Saharan African | Pakistani | Not reported (case reported from Korea) | African American |
Age (years)/gender | 33/M | 35/M | 66/M | 59/F |
Immunologic workup | Negative | None | None | Negative |
ESRD | No | No | Yes | Yes |
Clinical presentation | Fever, dyspnea, chest pain, shock | Central chest pain radiating to left arm | Chest pain | Chest pain |
ECG | No ST segment abnormalities | Inferior ST segment elevation | Not reported | No ST segment abnormalities |
Troponin | Initial troponin 13.2 ng/mL. No trend was reported | Initial troponin T 0.009 ng/mL. No trend reported | Not reported | Initial troponin I was 0.15 ng/mL, followed by 0.52 ng/mL and 0.63 ng/mL at two and eight hours, respectively |
C-reactive protein | 150 mg/L | Not reported | Normal | 57.8 mg/L |
Echo | LVEF 20% with global hypokinesia | Not reported | LVEF 40% with hypokinesia of the base to mid inferior wall and basal inferolateral wall and akinesia of the mid inferolateral wall | LVEF 50-55%, new RWMA in the anterior, apical, and inferior walls |
COVID-19 vaccination status | Not reported | Not reported | Received first dose 4 weeks prior | Received booster two months prior |
COVID19 symptoms/testing | Viral symptoms started six weeks prior to presentation. Testing showed +ve IgG but –ve PCR | Asymptomatic/testing was +ve during the same admission | Hospitalization with COVID-19 pneumonia 4 months prior | Asymptomatic/testing showed both +ve PCR and +ve IgG |
COVID19 pneumonia | Not reported | Chest X-ray was normal | Not reported | Chest X-ray was normal |
Coronary angiogram | Coronary CT angiogram: multiple aneurysms involving the RCA, intraventricular artery, and LCX | Coronary angiogram: large proximal RCA aneurysm (14.46 mm diameter) with occlusive thrombus. Medium-sized LCX aneurysm | Coronary angiogram: proximal RCA aneurysm with a diameter of 8.6 mm. Multiple stenotic lesions in the RCA and LCX | Coronary angiogram: aneurysmal left main artery ( mm), ostial LAD was subtotally occluded, LCX 90% eccentric ostial stenosis. Dominant RCA with 70-80% ostial stenosis |
Treatment | Medical management with IVIG, prednisone, and aspirin | Clot removed with an aspiration catheter | 2v-CABG: SVG to RCA, SVG to OM1 along with aneurysmal suturing | 2v-CABG: LIMA to LAD, SVG to OM2 |
Patient outcome | At 5-month follow-up, repeat coronary CT showed complete resolution of CAA | At 2-month follow-up, the patient had no cardiac complications | At 5-month follow-up, the patient has no cardiac complications | At one-year follow-up, patient was asymptomatic. However, nuclear stress test showed a new anterior myocardial wall defect |
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