Clarissa Campo Dall’Orto1*, Rubens Pierry Ferreira Lopes1, Mariana Torres Cancela2, Círia de Sales Padilha2, Gilvan Vilella Pinto Filho1 and Marcos Raphael da Silva1
1Therapy Center, Brazilian Society of Health Support Hospital, Brazil 2Medical Assistance Extreme South Hospital, BrazilFulltext PDF
A 62-year-old woman with COVID-19 had received three vaccine doses for SARS-CoV-2. Ten days after, the patient presented with inferior ST-segment elevations and was referred for an emergency angiography. Images of the Right Coronary Artery (RCA) and its Right Posterior Descending (RPD) and Right Posterior Ventricular (RPV) branches indicated intraluminal filling defects, suggesting a thrombus. The Intravascular Ultrasound (IVUS) suggested a subacute, homogeneous, echolucent thrombus in a large extension of the RCA, RPD, and RPV and an acute thrombus with a bright aspect, clear outline, and no signal attenuation in the RVP and mild to moderate atherosclerosis in the middle third of the RCA. We opted for dual antiplatelet therapy and complete anticoagulation therapy. After 7 days, a repeat coronary angiography revealed complete disappearance of the thrombi in the RCA and its branches. Optical Coherence Tomography (OCT) was performed for confirmation, showing the disappearance of the thrombi, except for a small residual thrombus in the RVP branch. It also identified mild to moderate atherosclerosis plaque in the middle third of the RCA. The invasive physiology of RCA was measured using the resting full-cycle ratio, indicating the absence of coronary physiology impairment. The patient recovered without further events and was discharged on the eleventh day of hospitalization.
Dall’Orto CC, Lopes RPF, Cancela MT, de Sales Padilha C, Filho GVP, da Silva MR. Extensive Right Coronary Artery Thrombosis in a Patient with Coronavirus Disease 2019. Ann Clin Case Rep. 2022; 7: 2228..